Maximizing Savings On Medical Claims
H.H.C. Group's Surprise Bill Resolution Assistance Service (SBRAS) is designed to enable payers and providers impacted by the No Surprises Act to resolve claims payments and avoid arbitration . The Act bans surprise billing for emergency services, regardless of where they are provided. Additionally, it bans out-of-network charges without notice for ancillary care or care by an out-of-network provider at an in-network facility in all circumstances.
Every second counts for both the provider and payor when a payor receives an unexpected, out-of-network bill for payment. HHC Group helps both parties by establishing an internal processes for fast assistance ahead of time. Here's how we can help you achieve appropriate settlements within the strict timelines for processing these surprise out-of-network claims and avoid the uncertainty of a decision by an Independent Dispute Resolution entity.
First 30 Days |
Open Negotiation |
IDRE Arbitration Period |
| Negotiation | Negotiation | Negotiation |
Even before the QPA is determined on a claim, HHC Group will attempt to negotiate a settlement for an appropriate amount and avoid the cost and risk of going to arbitration. We've successfully negotiated reasonable settlements on tens of thousands of claims. |
If the payor has remitted the QPA to the provider and they have rejected or questioned payment, both parties can still avoid the risk of potentially expensive arbitration. How? By having HHC Group negotiate a settlement on your behalf during the 30-business day Open Negotiation Period. |
Even after the 30-day Open Negotiation period and the filing by one of the parties to enter the Independent Dispute Resolution process, we will keep negotiating to achieve a settlement acceptable to both parties. |
| LEARN MORE | LEARN MORE | LEARN MORE |
First 30 Days |
| Negotation |
Even before the QPA is determined on a claim, HHC Group will attempt to negotiate a settlement for an appropriate amount and avoid the cost and risk of going to arbitration. We've successfully negotiated reasonable settlements on tens of thousands of claims. |
| LEARN MORE |
Open Negotiation |
| Negotiation |
If the payor has remitted the QPA to the provider and they have rejected or questioned payment, both parties can still avoid the risk of potentially expensive arbitration. How? By having HHC Group negotiate a settlement on your behalf during the 30-business day Open Negotiation Period. |
| LEARN MORE |
IDRE Arbitration Period |
| Negotation |
Even after the 30-day Open Negotiation period and the filing by one of the parties to enter the Independent Dispute Resolution process, we will keep negotiating to achieve a settlement acceptable to both parties. |
| LEARN MORE |
If a health plan determines that services provided to a plan enrollee do not qualify for coverage with the surprise billing and cost-sharing protections of the No Surprises Act, the enrollee can request an External Review of that decision. HHC Group, a URAC accredited Independent Review Organization conducts external reviews to determine whether health plans are complying with the surprise billing and cost-sharing protections under the No Surprises Act.
LEARN MORE
Health Insurance Payers Ask: How Should I React to the No Surprises Act and the Latest Surprise Billing Rule? That's a great question and we'll attempt to provide some definitive answers. I think we would all agree that there are still some surprises left in the No Surprises Act.
Congress passed the No Surprises Act ("Act") as part of the recent stimulus bill and it was signed into law on December 28. The major provisions of the Act go into effect January 1, 2022.
Maximizing Savings On Medical Claims
© 2024 HHC Group. All Rights Reserved.