Providers Won Most Surprise Billing Disputes in 2023
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Aug 23, 2024
In 2023, the federal government received more than three times as many surprise billing payment disputes it received in 2022, and provider groups continued to win the vast majority of cases while reaping higher payment amounts, according to new CMS data.
The No Surprises Act (NSA), passed in 2021, banned the practice of billing patients for the difference between what their insurer pays and what a provider charges when patients unknowingly receive care from an out-of-network provider. The law also established a Federal Independent Dispute Resolution (IDR) process that out-of-network providers and insurers can use to determine the OON rate that providers should receive if the two parties fail in their own attempts to negotiate.
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