What healthcare organizations need to know about Reg F and No Surprises

Billing transparency changes under Reg F and No Surprises in 2022

In 2021, billing transparency for consumers came into the spotlight with the passing of Regulation F and the No Surprises Billing Act. While these new regulations are focused on the debt collectors, they can have a major impact on the healthcare organizations themselves if the correct revenue cycle processes aren’t in place. Here’s a closer look at what these regulations are and what they mean for healthcare organizations in 2022.

What is Reg F?

The Fair Debt Collection Practices Act (FDPCA), which underpins Reg F, was created in 1977. This act included regulations around the ways that a 3^rd party debt collection agency could contact a debtor. Notably, the FDPCA was enacted in a time when voicemail, email, and text messages were not a prevalent means of communication.

Reg F provides guardrails for how collectors can and should utilize the communication methods that have emerged since 1977. While collectors have the primary responsibility for upholding these new regulations, part of a healthcare organization’s general oversight responsibilities is to make sure that their debt collection practices—third party or otherwise—are compliant.

What is the No Surprises Billing Act?

The No Surprises Billing Act, which is a result of the Consolidated Appropriations Act, was called “one of the most critical medical debt consumer protection laws since the Affordable Care Act”. The act is designed to protect consumers from unexpected medical bills, ban surprise billing and balance billing, and increase the amount of information a consumer is given at the beginning of the revenue cycle.

Surprise bills are a mounting issue in the United States– even for consumers with insurance coverage. According to the ASPE Office of Public Health Policy, 18% of insured emergency room visits included at least one surprise bill, with the out-of-pocket cost for the consumer falling at an average of $750 for childbirth, $1200 for anesthesia, and $2600 for surgical assistants.

While this bill is intended to increase competition within the healthcare industry and pave the way for more transparent pricing practices, it creates high stakes for healthcare organizations. Heavier administrative workloads, potential loss of revenue, and even disputes and litigation can result from non-compliance at the point of service.

How to stay compliant under Reg F and No Surprises

While these new regulations may feel daunting, they don’t need to be. Having the right processes in place can help you prevent low consumer satisfaction ratings, dispute cases, and litigation. When leveraged correctly, they can even increase consumer referrals and boost revenue. Find out what compliance experts have to say about using these new regulations to your advantage in our free live webinar.