Catherine Short speaks with Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX, on the topic of “The No Surprises Act – What You Need to Know.” Effective January 1, 2022, the No Surprises Act has implications for patients, providers, and insurance companies alike. The impetus behind the legislation, as well as the regulations, is to prevent patients from receiving bills for certain services that were performed or delivered by providers out of their plan’s network. The scope is limited and providers and plans alike need to take steps to understand the appeal process when a payment or claim is challenged. The purpose of this episode is to provide a brief overview of the evolution of the United States’ healthcare system and its relevance to the No Surprises Act. From there, the No Surprises Act and regulations will be explained, along with the appeal process. Finally, compliance tips will round out the show.   AI TRANSCRIPT – misspellings may occur The No Surprises Act * 28:19 SUMMARY KEYWORDS surprises, providers, compliance, act, bill, IDR, lawsuit, patient, network, plan, states, party, air ambulance, individuals, payment, services, coverage, alternative dispute resolution, law, procedures SPEAKERS Catherine Short, Rachel V. Rose   Catherine Short  00:02 Welcome! and, let’s “1st Talk Compliance”. I’m Catherine Short, Partnership Marketing Manager at First Healthcare Compliance. Thanks for tuning in.   This show is brought to you by First Healthcare Compliance as part of our commitment to provide high quality complimentary educational resources.  We help create confidence among compliance professionals throughout the United States.  Please show your support by taking a moment to provide a review on Google, Facebook or iTunes.  You can also follow us on Instagram, Twitter and subscribe to our YouTube channel.   Catherine Short  00:42 On today’s episode, we are speaking with Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX, on the topic of “The No Surprises Act – What You Need to Know.” Effective January 1, 2022, the No Surprises Act has implications for patients, providers, and insurance companies alike. The impetus behind the legislation, as well as the regulations, is to prevent patients from receiving bills for certain services that were performed or delivered by providers out of their plan’s network. The scope is limited and providers and plans alike need to take steps to understand the appeal process when a payment or claim is challenged. The purpose of this episode is to provide a brief overview of the evolution of the United States’ healthcare system and its relevance to the No Surprises Act. From there, the No Surprises Act and regulations will be explained, along with the appeal process. Finally, compliance tips will round out the show.   Catherine Short  01:53 Before we begin, I would like to mention at First Healthcare Compliance we strive to serve as a trusted to resource for compliance professionals and every month we celebrate their hard work and dedication with our Compliance Super Ninja recognition. For this episode, we’re spotlighting Super Ninja Julie Garcia, Business Office Manager at Coastal Vascular Center. Julie says “Coastal Vascular Center has three office locations and yet the whole group works as a team. They all respond well to the compliance updates and changes. I am fortunate to have such a close knit, caring group of professionals to work with every day.” Congratulations Julie!  Our team is honored to have the privilege of working with you. Catherine Short  02:37 So thank you, Rachel, for joining me on 1st Talk Compliance. It’s a pleasure to have you on.