Healthcare providers, take note: effective January 1, 2022, your office must comply with the No Surprises Act. That means it’s your responsibility to make sure that your patients know if they will be facing out-of-network charges, as well as how to file complaints if they do receive surprise medical bills. 2021 has been yet another overwhelming year, but we’re here to make compliance as easy and painless as possible.
So, here’s what you need to know to be ready.
What Is the No Surprises Act?
Everyone loves surprises…except when the surprise is a hefty medical bill. According to the Kaiser Family Foundation, about 1 in 5 ER visits and 1 in 6 in-network hospital stays generate “surprise” bills as a result of balance billing.
The No Surprises Act eliminates surprise out-of-network bills for most emergency services, as well as ancillary care from out-of-network providers working at in-network facilities. Here’s how it works.
No Surprises Act Requirements
To effectively address surprise medical bills, the No Surprises Act requires covered facilities to:
- Limit the amounts patients are billed for out-of-network emergency services to what they would normally pay under the in-network price-sharing provisions of their health plan. The same stipulation applies to ancillary out-of-network services provided during a procedure or a stay at an in-network facility.
- Obtain patient consent for out-of-network charges before they happen, and get patients to sign a waiver consenting to the charges. Note: You do not have this option if you’re providing emergency care or ancillary care during an in-network hospital stay.
- Notice and consent forms must be available in writing in the 15 most common languages for your area. If your patient can’t read any of those languages, a qualified interpreter must be provided.
- Provide a written notice about the No Surprises Billing Act and the process for filing complaints about surprise medical bills in English and in the 15 most common languages other than English in your area. This information must be available on your public website and posted in your office.
- Ensure that patients understand their rights under the act.
Violating the No Surprises Act carries a $10,000 penalty per violation. Compliance spares you that penalty. It also enhances the patient experience and fosters trust between patients and providers.
Translation Best Practices for the No Surprises Billing Act: How to Ensure Patients Understand Their Rights
Healthcare billing and health insurance, in general, are notorious for being opaque to patients. If you haven’t received an Explanation Of Benefits (EOB) or a medical bill that left you scratching your head, you’re in the minority. And it’s probably only because you work in healthcare.
Ensure your patients understand their rights under the No Surprises Act by using plain language and avoiding jargon. For example, one of our clients makes sure that all of her healthcare documents are written at or below an 8th-grade reading level.
If you haven’t already done so, now is also the time to ensure your current language access plan is able to meet the criteria of the act. Be prepared to provide notices in your area’s top 15 languages. Having documents pre-translated by a professional linguist team can ensure accurate and contextually sound translation.
The Centers for Medicare & Medicaid Services (CMS) has provided standard notice and consent forms for your use. To streamline the translation process, create a template form that can easily be replicated for each language. The American Hospital Association (AHA) has requested that CMS translate the form into the 15 most widely spoken languages nationwide. This will make compliance easier, but remember that these may or may not correspond to the 15 most common languages local to your facility.
Also, consider that patients who don’t speak any of those top 15 languages will need interpreting services. To add to that, even with translated forms, Limited-English-Proficient (LEP) patients may need additional help from an interpreter to understand how our US health insurance system works.
How to Find The 15 Most Common Languages
These are an excellent starting point, but they may not be sufficient. Follow up by searching for additional languages specific to your service area. For example, one of our clients uses data from their Video Remote Interpreting and On-Demand Phone Interpreting encounter reports and census data to identify smaller pockets of potential linguistic needs.
It's particularly important to be aware of communities in your area that speak less common languages so that you can plan ahead for them. Pro tip: If these languages use a different alphabet and font, this can cause unexpected formatting errors in your translated form. Leverage your language partner to review the translated document and ensure all of the text is displaying correctly.
Helpful Tips for Offering Interpreting Services Under the No Surprises Billing Act
If your patient doesn’t speak one of the top 15 languages in your area, you’ll need an interpreter to make sure they understand their rights under the No Surprises Act. It’s vital to use qualified interpreters, preferably with a healthcare background. The interpreter needs at least a basic understanding of the US medical and insurance system to accurately convey the information into the target language.
Second, make sure that all of your forms are clear, direct, and easy to understand in English. This will make it easier for an interpreter to help your patient understand them.
How ULG Can Help
At United Language Group, our deep health care expertise allows us to keep language access simple. Our translation services are designed to help LEP patients and providers overcome health literacy and comprehension difficulties. We use culturally relevant terminology to ensure patient understanding, and our thorough formatting review process ensures that nothing gets lost in translation.
Plus, with ULG’s Octave™ technology suite, you’ll have access to a complete language platform to streamline the translation process. For interpreting, we offer over-the-phone, on-site, and video remote interpreters in 200 languages.
And of course, our knowledgeable staff is always available to offer advice and assistance. If you have questions about the No Surprises Billing Act or any other question related to language access in healthcare, don’t hesitate to get in touch!