What is the No Surprises Act and how does it affect my practice?
The No Surprises Act limits balance-billing for certain out-of-network and emergency care and requires good-faith estimates for uninsured and self-pay patients. For most independent practices, the practical impact is the good-faith-estimate workflow plus the out-of-network dispute (IDR) process for the situations it covers.
What actually matters
- Uninsured and self-pay patients must get a good-faith estimate of expected charges
- Surprise balance-billing is restricted for certain out-of-network and emergency situations
- An Independent Dispute Resolution (IDR) process exists for OON payment disputes
- There are provider disclosure requirements about balance-billing rights
- For most practices the real lift is the good-faith-estimate process
Common questions
Does the No Surprises Act apply to my in-network claims?
Its balance-billing limits mainly target out-of-network and emergency scenarios. The good-faith-estimate duty applies to uninsured and self-pay patients more broadly.
Where Volari fits: For out-of-network underpayments, the Act's IDR process is one more lever to challenge a claim that paid below fair value.
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