The survey of more than 48,000 physicians in 45 states found payers are delaying award payments and sometimes completely denying them, which AFHC said risks destabilizing the No Surprises Act passed by Congress that went into effect early 2022.
No Surprises aims to protect consumers from pricey medical bills resulting from disputes between providers and payers, particularly when patients unknowingly receive care from an out-of-network provider at in-network facility.
The law creates a process for providers and insurers to resolve payment disputes by entering into baseball-style arbitration. A third-party arbiter picks one payment offer, submitted by either side, as part of the independent dispute resolution process.
