This legislation has the potential to drastically reshape the economics of healthcare in America, but it remains unfamiliar to those it affects most—namely, patients, doctors and outpatient surgery centers.
HHS, along with other federal agencies, have released the first set of regulations that ban surprise billing and out-of-network charges for several types of services. More regulations are expected, especially those pertaining to the independent dispute resolution process that providers and payers will have to undergo if they cannot agree on out-of-network claims payment.
Zelis highlights how employers, payers, and consumers are integrating digital tools to manage healthcare costs.