No Surprises Billing (Medi-Cal)

This course will explore the No Surprises Act, which was signed into law in December 2020 to protect patients from surprise bills charged by providers and physicians. The law protects against surprise bills in three scenarios: patients going to in-network facilities but being seen by out-of-network physicians; emergency care administered at an out-of-network facility; and air ambulance transport. The course also examines how providers and payers settle payment disputes for contested claims, as well as special circumstances where patients can be held liable even when the No Surprises Act should apply.

  • Name the reasons for the creation of the No Surprises Act and what it does
  • List the steps of the Federal Independent Dispute Resolution (IDR) process
  • Name concerns and challenges that healthcare providers and facilities need to be aware of

Additional Information

Advance Preparation: None

Prerequisites: None

Program level: Basic

Delivery Method: Self-study

CPE Field of Study: Business Law



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