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Providers Cry Foul Over New Surprise Billing Rule's Arbitration Process
FierceHealthcareLink to more items from this source
Oct. 4, 2021

"[P]roviders took umbrage with a key direction the rule gave to the arbiter. The final rule states that when deciding between the amounts, the arbiter should pick whichever amount is closest to the qualified payment amount (QPA), which is an insurance plan's median contract rate for the same or similar service in a geographic area.... The rule means providers will have to prepare a game plan to show that their amount needs to be different from the QPA."

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