Tired of Facing NSA Challenges Alone? Part 2
Navigating NSA claims can be quite challenging - especially when faced with a variety of complex regulations with minimal education on them. It’s easy to feel overwhelmed and unsure of where to begin, but you are not alone in this journey.
The Issue: Gaps in Provider Communication
Miscommunication often results in confusion and delays. With the inability to provide clear and concise explanations and instructions can lead to incorrect billing information, which ultimately contributes to dissatisfaction for patients. Additionally, there may be challenges in complying with regulations, such as the accurate application of RARC.
The Solution: Robust Provider Communication
In order to minimize miscommunication, implementing an automated explanation that references laws, outlines how the payment was calculated, and provides a contact for questions can increase confidence in payers while managing claims. In addition, a white-labeled support line staffed by NSA experts to answer questions prior to appeal will ensure that payers can navigate the complexities of the NSA process with ease.
The Issue: Overwhelming Open Negotiations & IDR
Unclear payment calculations slow negotiations and arbitration, creating heightened payer frustration as IDR cases rise. With a strain on resources and minimal understanding of timelines, payers often feel overwhelmed.
The Solution: Avoiding Open Negotiation & IDR Management
The best strategy is to completely avoid going into IDR at all. Being educated on jurisdiction for cases, QPA calculations and financial impact of taking a case to IDR can significantly decrease the need into going into IDR. However, if a case does go into IDR, a dedicated out-of-network and person-to-person negotiation expert specifically trained in Surprise Billing laws, timelines, and processes can offer valuable support and lead to a more favorable outcome.
The Issue: Insufficient Outcome Tracking & Member Support
Manual tracking of provider appeals, IDR outcomes and missing processes for member updates, education, and support creates confusion between payers and members about the status of their cases.
The Solution: Full Case Management & Member Engagement Support
Tracking cases can become more efficient with an interactive platform that tracks each claim from initial payment to outcome and prompts users for actions needed throughout the process.
The Solutions You Need Start with Reliant
The answers you are looking for are within Reliant Health Partners. With decades in the industry and a deep knowledge of NSA statues and regulations, our experts are ready to guide you through navigating these issues. We aim to proactively avoid open negotiations and Independent Dispute Resolutions (IDR) and with cases that do proceed to IDR, we maintain a best-in-class IDR win rate.
Powered by our ClaimSaveIQ engine, our NSA Navigator offers:
A Defensible QPA Calculation
Provider Education
You no longer have to face the complexities of NSA alone - Reliant is here to be your guiding hand.
Maximize Savings. Minimize Noise.
Get in touch with our team.