Why Your EHR is Key in Adhering to the No Surprises Act

The No Surprises Act, which took effect on January 1, 2022, was a breath of fresh air for healthcare consumers across the country. But has the law lived up to its promise so far?

What is the No Surprises Act?

Touted as patients’ protection from unexpected medical bills, the No Surprises Act was landmark legislation intended to unburden patients from skyrocketing healthcare expenses. However, many patients are still getting surprise medical bills despite having the law in full effect.

While there might be instances where practices intentionally conceal billing details or overwhelm patients with medical and billing jargon to take advantage of them, these cases are far and few between. Often, patients’ poor health insurance literacy and a practice’s lack of tools to communicate potential costs are the culprits for unexpected medical bills.

Addressing Poor Health Insurance Literacy

There’s no denying the complexities of health insurance policies. And let’s be honest, no one has the time to sift through hundreds of pages of policy stipulations often riddled with legal terminology. For the average patient, these lengthy documents further complicate an already convoluted subject.

On the other hand, understanding health insurance’s intricacies is vital if you don’t want to find yourself in a financially precarious situation. A recent study found that one in four Americans pin their surprise medical bills on a lack of health insurance understanding.

Considering the complicated nature of the country’s health insurance system, it should be incumbent upon medical practices to help patients grasp their insurance benefits better. You can start by informing them about how copays and deductibles work.

The above-mentioned survey revealed that half of the respondents believed copays count towards deductibles, which is not the case in most plans. Some 22% also thought that low-deductible plans are ideal for healthy and low-risk individuals when it’s actually the other way around.

Going the extra mile to clear up insurance confusion and inform patients of their potential out-of-pocket expenses can boost your practice’s regulatory adherence and help you avoid penalties while saving your patients from unpleasant surprises.

Surprise Medical Bills Create Bigger Problems

With increasing prices and record-high inflation rates, the last thing patients want to see is an unexpected invoice from their physician. Not only do surprise medical bills hurt your patient satisfaction and retention rates, but they also discourage patients from seeking medical attention in the first place.

According to the latest data from Discover, ballooning medical debt is driving more patients to delay non-emergency medical care. Of the 1,521 people the firm surveyed, 52% said they had put off visiting a specialist, 41% delayed seeing a physician when they got sick, and 31% stalled their doctor’s prescribed treatment plan because of medical debt.

Both patients and medical practices stand to lose whenever care is delayed. As more patients suffer from medical debt due to surprise bills, more patients are bound to delay care. Consequently, patient appointments and procedures will dwindle, revenue will dip, and before you know it, your bottom line will take a hit.

Read More: How Practice Management Software Can Solve Cash Flow Problems

How Your EHR Software Can Help

Maximizing revenue while giving patients the best quality care for their budget is possible with the right EHR software. As with any modern challenges medical practices face, the solution often lies in your EHR’s capabilities.

An all-in-one platform like Meditab’s Intelligent Medical Software (IMS), which comes with complete medical billing tools, can streamline your entire revenue cycle and simplify your quotation, invoicing, and payment processing workflows.

Read More: What to Look For in a Medical Billing Software

Reliable billing solutions make it easier to inform patients of potential costs and prevent unexpected bills. Plus, with IMS, you not only get billing functionalities but also patient-centric tools like IMS Care Portal and Patient App.

With advanced mobile tools, IMS empowers patients to interact with your practice from anywhere, including viewing patient statements, paying bills, and more.

Whether from a business or clinical point of view, surprise medical bills have always been a thorn in both patients’ and medical practices’ sides. But with a powerful EHR like IMS, you can keep your promise of a fair, quality healthcare service to your patients.