Zelis Unveils Solution to Tackle Payer IDR Challenges
Zelis has introduced an AI solution to help health insurers streamline the No Surprises Act's Independent Dispute Resolution process.
CMS Finalizes Rule to Simplify Payer-Provider Disputes Under No Surprises Act
CMS finalized a new rule aimed at streamlining the No Surprises Act’s overwhelmed arbitration system. Provider groups largely welcomed the reforms — though some industry leaders said additional changes are still needed to address alleged misuse and improve transparency.
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New Webinar: The Payer AI Readiness Gap: Why Better Data Will Define the Next Era of Health Plan Performance
We'll explore why the next era of payer performance will depend on building a trusted data foundation that connects people, providers, and relationships across the enterprise.
48 Groups Want Trump Administration To Improve Process to Resolve Payer-Provider Disputes
A coalition of employer and consumer groups is urging the Trump administration to crack down on alleged abuse of the No Surprises Act’s independent dispute resolution process.
‘This is Crazy’: Health Experts Call for Changes to the No Surprises Act
Industry leaders say the No Surprises Act is protecting patients from surprise bills, but its Independent Dispute Resolution system is being overused and exploited, driving up costs and prompting calls for reform.
Is It Time to Change the Independent Dispute Resolution Process of the No Surprises Act?
The No Surprises Act protected patients from surprise bills, but its Independent Dispute Resolution process has become controversial as insurers accuse some providers of exploiting it at scale.
President Trump Can Act Now To Make Healthcare Affordable
The Trump administration can immediately take these two price transparency administrative actions to reduce costs and improve affordability.
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The Power of Real World Data to Study Women’s Health at Scale
Veradigm examines key clinical trends, comorbidity profiles, and treatment trends across adolescence, reproductive years, and peri-/post-menopause. Download it today!
Price Transparency Enforcement Is Still A Shared Responsibility
Despite all the noise around the updates, there’s one area that’s been conspicuously absent this year: enforcement of patient estimate requirements.
Beyond Broken Links: The High Stakes of Provider Directory Accuracy in the No Surprises Era
Inaccuracies don’t just erode trust — they lead directly to surprise billing events, missed appointments, care delays, and in some cases, enforcement action.
CMS Lowers No Surprises Act Fee After Court Nixes Price Hike
CMS recently announced that it will change the administrative fee that providers and insurers must pay when initiating a reimbursement dispute under the No Surprises Act — the agency is lowering the fee from $350 to $50. This move came a week after the Texas Medical Association won a court case challenging HHS over its 600% price hike on the fee.
3 Recent Healthcare Wins for Employers
Amid the difficult healthcare environment, it's important to note that there have been some wins for employers, said Katy Spangler, senior advisor of the American Benefits Council, during the Midwest Business Group on Health conference held Tuesday. These wins include the No Surprises Act and price transparency rules.
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Top 7 Modern AI-Powered EAP Providers for Global Workforces in 2026
Discover the top AI-powered EAP providers for 2026. Compare platforms like Kyan Health and Spring Health on triage speed, global reach, and clinical quality to transform workforce wellbeing.
What Keeps One Advocate up at Night About the No Surprises Act
Patricia Kelmar, healthcare campaigns director at the Public Interest Research Group, is an advocate for the No Surprises Act. But there's one thing that bothers her: the fact that providers can ask patients to waive their surprise billing protections, she said Tuesday when speaking at the AHIP Medicare, Medicaid, Duals and Commercial Markets Forum in Washington, D.C.
Initially Aggressive on Deadlines, NSA Rollout Becomes Measured
If the NSA-implementing agencies could plot out and publish their plan for adopting standards, publishing regulations, and setting new compliance dates for the NSA AEOB and provider directory requirements, it would help tremendously to level set on expectations and help organizations budget and plan for actual implementation.
The Future of Digital Health and Healthcare IT in a Post-Covid World
Implementing and pursuing innovation in digital health and healthcare IT should be a priority for all U.S. healthcare providers and payers — especially as the lessons and response to the Covid-19 pandemic become permanently part of our everyday lives.
Building on the groundwork laid by the No Surprises Act
Although the “Requirements Related to Surprise Billing: Final Rule,” was released on August 19th, the No Surprises Act roll-out is far from complete. Its complexity means adherence, oversight, and enforcement, as well as system and process changes, are still works in progress.
1 in 5 Americans received surprise bills despite law, many lack health insurance literacy, reports find
Skyrocketing medical bills and a lack of understanding in the healthcare system is putting financial stress on Americans in 2022, several recent reports have found. Despite the No Surprises Act, which protects consumers from surprise billing, many Americans said they’re still receiving unexpected bills, and a low healthcare literacy is making it difficult for them to know how to handle high medical bills, the surveys find.