However, unlike the previous bill that would have set a benchmark reimbursement on rates, this bill outlines a new procedure. If the provider and payer cannot resolve on a price in a 30-day negotiation period, the bill requires the next step to be arbitration. An arbiter enters the discussion and defines a fair amount for the services based on what the providers are typically paid for such services. The final payment decision would then be made. However, it should be noted that the arbiters are not able to take Medicare and Medicaid rates into account when settling these debates. Additionally, the previous bill had stalled in negotiations on whether ambulance services would be included. This stimulus bill prohibits surprise billing for air ambulance services but excludes ground ambulance services.
These changes will officially take effect in 2022, so providers should be aware and prepared for when those measures are officially put into place. Contact Outsource Receivables Inc. if you have questions on how to improve your medical billing and how this new bill will affect your revenue going forward.