Self-funded plans need to check their administrative services agreements to see exactly how much responsibility they might bear for decision-making…. Who will make decisions and represent the plan when it comes to arbitration? Will it be Tom, Dick or Harry?
Don’t Let the No Surprises Act Take Your Health Plan by Surprise
” The new rules also limit a plan’s ability to deny emergency claims…. Emergency care is defined broadly for the purposes of these rules…. [M]ost health care claims payers and processors are not prepared to run with this standard yet.” MORE >> MZQ Consulting, LLC
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