Surprise Billing Regulation is Going to Surprise A Lot of Providers

As we wrap up 2021 and prepare ourselves for 2022, it’s fun to look forward and think about what may surprise us in 2022.  In a really ironic way, I think one thing that is likely to surprise healthcare most in 2022 is the Surprise Billing regulations.

I was recently in Philadelphia visiting with Edward Bukstel and he said the same thing “The Surprise Billing regulation is going to surprise a lot of providers.”

At the end of the day, the surprise billing legislation is basically requiring healthcare organizations to not pay high out-of-network billing costs associated with emergency services.  Plus, they must inform the patient of the potentially high costs they are incurring.  However, for the most part the act essentially means that patients don’t need to worry about in-network or out-of-network.

What impact this will have on healthcare organizations and payers is a hotly disputed topic.  Plus, it likely depends a lot on the patient population of the organization.  We’re going to find out how many were relying on these high cost out of network bills and which ones weren’t.  Understanding this is going to be an important step for most healthcare organizations.

I personally never worry about the payers, because they always win in these types of things.  They can always raise premiums to make up for any of these changes.  Although, some argue that these changes will actually allow payers to lower premiums.  I can’t remember a payer ever lowering my premium, but I guess in theory it’s possible.

I’ll admit that I’m a bit of a novice on this topic.  However, I think that’s also true for many healthcare organizations that don’t know how much “surprise billing” they’ve been doing either.  My prediction is that in 2022, we’re all going to become much more informed on surprise billing and what it’s been doing for our organization.  The real question is whether we’re going to be proactive in our efforts to learn or whether we’re going to wait for the surprise drop in revenue to then take the time to figure it out.

How are you and your organization approaching surprise billing?  Are there any tools you’re using to assess how this will impact your organization?

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

   

Categories