Complying With the No Surprises Act: Necessary Forms and Information

The No Surprises Act went into effect January 1 of this year. An excellent overview of this legislation and its affect on ambulatory surgery centers (ASCs) is provided in the December 2021 edition of the Ambulatory Surgery Center Association's ASC Focus magazine: "Provisions Related to Surprise Medical Billing Become Effective in New Year."

This legislation is intended to protect patients from receiving unexpected medical bills. It affects most ASCs by requiring that they provide a good faith estimate to uninsured and self-pay patients. This is intended to give these patients, prior to the day of surgery, an estimate of how much their healthcare services will cost.

This will be an important part of the ASC's patient financial counselor's duties. This good faith estimate must include anticipated fees for services/supplies provided by the ASC and other providers. An example and requirements for this good faith estimate can be found here.

Additionally, ASCs must publicly display information about the availability of a good faith estimate in their lobby, scheduling area, and on their website. This document must be personalized for an individual center. An example of this disclosure is available here.

The information above is provided to help ASCs ensure they are fully compliant with the No Surprises Act. CMS also released a zip file of valuable information about this law that may help your ASC understand what its role is in ensuring that uninsured and self-pay patients are fully aware of how much their healthcare services will cost. This zip file can be found here.