Neil H. Baum, MD, presented “No More Surprises: An Overview of the No Surprises Act” for the Grand Rounds in Urology audience in October 2021.
How to cite: Baum, Neil H. “No More Surprises: An Overview of the No Surprises Act.” October 2021. Accessed Jul 2024. https://grandroundsinurology.com/no-more-surprises-an-overview-of-the-no-surprises-act/
No More Surprises: An Overview of the No Surprises Act
Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, summarizes the rules and implications of the No Surprises Act against unexpected out-of-network medical bills. He defines a surprise medical bill as one where a patient receives an often large bill for the difference between the out-of-network provider’s fee and the amount covered by the patient’s health insurance, and he notes that 2 out of 3 American adults are worried about these bills. Dr. Baum explains that the No Surprises Act, which was signed into law by Congress on December 27, 2020, prohibits out-of-network providers from billing patients more than in-network amounts, and that a violation brings a $10,000 fee per occurrence. He says that this most impacts out-of-network providers, emergency room physicians, and providers that a patient typically does not select, including hospitalists, radiologists, anesthesiologists, and pathologists. Dr. Baum then discusses the process that occurs if a provider disagrees with a payment, noting that the losing party of an Independent Dispute Resolution (IDR) must ultimately pay the cost of the IDR.
For more commentary on practice management from Dr. Baum, visit his Improving Your Urology Practice page. For more on using EMR templates, check out our original lecture series, Leveraging the Electronic Medical Record to Improve Prostate Cancer Care.
ABOUT THE AUTHOR
Neil H. Baum, MD, is a Clinical Professor of Urology at Tulane Medical School in New Orleans, Louisiana. He is also a retired urologic surgeon. Additionally, Dr. Baum serves as the Medical Advisor to Vanguard Communications Group. Dr. Baum is the author of Marketing Your Clinical Practice - Ethically, Effectively, and Economically, which is in its 4th edition, has sold over 175,000 copies, and has been translated into Spanish. He also wrote The Complete Business Guide to a Successful Medical Practice, which was published in 2015. Dr. Baum was the columnist for American Medical News for more than 25 years. Dr. Baum also wrote the popular column, “The Bottom Line,” for Urology Times for more than 20 years. He is a requested speaker each year to the Practice Management Seminar for the American Urological Association (AUA), where he discusses techniques for making urology practices more efficient and more productive. He has written more than 9 books on practice management and over 250 peer-reviewed articles on various urologic topics. Dr. Baum is also the medical advisor to Vanguard Communications Group.
