As our hearts and prayers go out to Damar Hamlin and his family for a speedy recovery after his on-field medical emergency, we are reminded of the complexities of emergency care, especially if ongoing care is needed. Even after the immediate crisis has passed, post-stabilization care may still be needed.
The No Surprises Act has been instrumental in protecting patients from balance billing due to these emergency services with out-of-network providers at in-network facilities. However, situations like Damar Hamlin’s create challenges because payers are required under NSA to do the impossible: separate medical services provided into NSA claims and post-stabilization claims when codes to facilitate this do not exist. Meaning payers face the risk of compliance issues and overcharging members.
Our NSA Navigator solves this impossible task by integrating sophisticated logic into our claim processing engine. Contact our experts to see what NSA Navigator can do for you.