HOSPITAL PRICE TRANSPARENCY
NO SURPRISE BILL, GOOD FAITH ESTIMATE
Is your organization ready to comply with the Price Transparency Rule?
Are you informed about new requirements in the Price transparency and No Surprise Bill regulation
MEET MORE THAN COMPLIANCE AND GROWTH
OPPORTUNITIES IN THE OPPS FINAL RULE
WE ARE A COMPLIANCE OUTSOURCING WORKING AS YOUR TECHNOLOGY PARTNER
- Reduce Administrative Burden
- Constant review and audit of existing and new requirements
- Get tailored solutions and compatible with your current system
WE UNDERSTAND COST TRANSPARENCY AND
NEW BILLING REGULATIONS
The final hospital price transparency rule (CMS 1717-F2 Final Rule) took effect on January 1, 2020 and requires hospitals to publicly post standard charges for all items and services.
- Consumer-Friendly List of Standard Charges for 300 Shoppable Services.
- Comprehensive machine-readable file including Gross charges, Discounted cash prices, Specific negotiated rates, De-identified minimum and maximum charges.
- Plain language descriptions.
CMS’s established fines
Up to $5,500 PER DAY or $2,007,500 FOR FULL CALENDAR YEAR
The No Surprises Act, passed in December 2020, limits the amount patients pay for out-of-network services to their cost-sharing amounts had the services been in network.
January 2022
- Establishes payer-provider independent dispute resolution process for out-of-network bills.
- Provide Good Faith Estimates no later than 3 business days after receiving the request; or no later than 1 business day after the date of scheduling.
- Meet content and data elements requirements for good faith estimate submission.
CMS’s established fines
Up to $10,000 for each violation in any case where surprise billing is prohibited.
COMPLIANT, SECURE, EFFECTIVE
Meet CMS Mandates
- Hospital Price Transparency Rule
- No Surprise Bill
- Good Faith Estimate
Demonstrated Security
- HIPPA Compliant
- No Surprise Bill
- Store, manage and publish data in a secure platform
Easy Implementation
- Fully managed cloud deployment
- Informed by real-time claims data
- Cost-effective and simple pricing
Consumer Friendly-tool
- Multiple search options and plain language descriptions.
- Customize and easily accessible directly from your hospital’s website.
- Allow patients to easily compare cost estimates for the same procedure across settings.
Machine Readable File
- CMS format requirements.
- 300 shoppable services that can be read by other computer systems and enable consumers to review all types of listed charges.
Good Faith Estimate
- CMS format and data elements requirements.
- Provide patients with accurate Good Faith Estimates with the click of a button.