The No Surprises Act (NSA) is a consumer protection law designed to protect patients from unexpected billing. However, compliance with the NSA has been challenging for payers, with CMS audits revealing incorrect qualified payment amount (QPA) calculations, providers continuing to send balance bills to patients, and the independent dispute resolution (IDR) process struggling to keep up with the caseload. This white paper includes:
Exponent Health has deep expertise in out-of-network claims and the No Surprises Act. Our expertise combined with technology-driven accuracy, a strong focus on compliance, and effective provider education is delivering exceptional results.
Only 2.4%
appeal rate during open negotiations
Only .04%
rate of claims entering into independent dispute resolution (IDR)
99% success
rate on IDR cases