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New Law Requires Transparency and Prohibits Surprise Billing
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[Guidance Overview]
Jan. 15, 2021

"The No Surprises Act sets up a process that health plans and providers must follow when a bill for emergency services is sent to the plan by a non-participating provider.... Health plans must send an initial payment or a notice of denial of payment to the provider or facility within 30 calendar days of the non-participating provider sending the bill. The provider and the plan may initiate negotiations to determine a payment amount agreed on by the provider or facility and the plan for the service[.]"

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