Administrator’s Corner: How do you feel about the No Surprises Act and how will it impact RCM?

Erica Palmer

Senior Content Marketing Manager

No one understands the struggles and triumphs that ASC leadership experiences like those who have gone through it themselves. We understand Administrators, Business Office Managers, Chief Nursing Officers, Nurses, and everyone else who makes an ASC run successfully because at one point, we were standing right in your shoes.

Welcome to HST’s Administrator’s Corner 👋 Together, we’ll be addressing current issues that ASC leadership are facing to help solve your most pertinent and difficult problems. The advice below is proven and actionable, and we hope you find it helpful!

Question: How do you feel about the No Surprises Act and how do you think it will impact revenue cycle management?

Dean Brown
VP of Business Development, HST Pathways
Former ASC Admin for 22 years in Alabama

The No Surprises Act is long overdue and will not only help healthcare consumers, but also healthcare providers. Healthcare providers will need to develop or purchase a system to provide accurate out of pocket estimates for their patients and a method in which to communicate this data to the patient. Until recently, patients have not had the ability to receive a text that explains their out-of-pocket expenses and then allows them to click on the same text and pay their portion of their healthcare service. As a former administrator, I used a technology that handles this workflow and I personally understand the value of what a system like this offers. The NSA will enhance healthcare providers ability to capture more of the patient out pocket responsibility and have a positive impact to their accounts receivable and days in AR.

Pierre Devaud
Sales & Relationship Manager, Patient Access, HST Pathways
Former ASC admin for 7+ years in New York

My concern regarding the No Surprises Act is the risk we now bear as a result of this new law. There are several provisions that sound onerous to the ASC; thankfully penalties have not yet been imposed. One example is the potential for arbitration if a good faith estimate underbids cost by more than $400. Whether a GI procedure originally was thought to be was preventative and became diagnostic, or an ortho procedure became more complicated intra-op, there are compelling reasons an ASC could miss the mark on the $400 threshold while being committed to pricing transparency. My physician ownership’s commitment to pricing transparency was a major driver in my administrative integrity and sensitivity to patient experience, but it remains to be seen how this will play out for our industry.

Kathi Gascho, RN, BSN
Senior Quality Assurance Engineer, HST Pathways
Former ASC Director of Nursing in Arizona

As a consumer, I would never make a large purchase without knowing what the cost for me would be. I feel like this is simply expanding this out to consumers who are having a surgery or procedure. Ideally, the No Surprises Act will do a couple of things: increase the trust in healthcare providers through transparency and increase the likelihood that providers/facilities will be able to collect the money owed since the patient will be aware of the cost well in advance of the procedure.

Donna Griggs, RN BSN MPH
Clinical Training Specialist in Learning & Development, HST Pathways
Former ASC Admin and CNO for 16 years and RN for 30 years in Kentucky, Mississippi, and Tennessee

I believe that ASCs are not the reason for this federal law! At the two centers where I was an administrator, we worked with our patients, the physician providers, anesthesiologists, laboratories, vendor reps, and insurance providers to give the patients a complete expectation of the costs and patient responsibilities before procedures were scheduled. That is part of the beauty of ASC’s elective, efficient, and exceptional care. Healthcare in this country is some of the best, however, it is not without costs. Price transparency should be provided for any medical service when possible. Patients and or patient advocates need to be involved and ask questions of all providers. Most providers in ASCs are in-network working with community partners to provide quality care covered by local insurance plans. However, as more procedures move to ASCs where devices or implants are involved, each case must be thoroughly vetted, so there are No Surprises to the patients or the centers.

Dorothy L. Immel
HST Practice Management Consultant, HST Pathways
Former Regional Business Office Manager and CBO Director in Texas & Oklahoma

I feel that the No Surprises Act is simply mandating what is already best practice. It is just as important for patients to be able to fit their surgeries into their budget as their schedule – especially those who will be paying out of pocket. Both Patient Satisfaction and Net Revenue will benefit from this practice, as a well-informed patient with whom the center has been working well in advance of the surgery is much more likely to pay their balance in full.