The No Surprises Act is a critical component of the new CFPB Advisory Opinion, and compliance with this legislation is now mandatory for medical debt collectors. The No Surprises Act aims to protect consumers from unexpected medical bills, particularly in cases involving out-of-network services that patients did not actively choose. Collectors must ensure that the debt amounts they are pursuing comply with the federal protections offered by this act.
Steps to Ensure Compliance with the No Surprises Act:
- Verification of Charges: Collectors must verify that the charges being pursued comply with the No Surprises Act. This involves confirming that the services billed were part of an in-network agreement or that the patient was properly notified and consented to out-of-network charges. Collectors must work closely with healthcare providers to obtain and verify this information. This requires coordination across multiple departments within healthcare facilities, including billing, insurance, and patient care departments, to ensure all charges align with the requirements of the No Surprises Act.
- Reasonable Market Rates: The No Surprises Act also requires that any charges for out-of-network services reflect reasonable market rates. Collectors must ensure that the amount being collected does not exceed these limits, which may involve comparing the charges against regional benchmarks or established rates for similar services. TSI’s data analytics tools enable collectors to compare billed amounts against predefined benchmarks to ensure compliance. This not only protects consumers from unfair billing but also reduces disputes and potential legal action.
- Collaboration with Providers: Collectors must collaborate with healthcare providers to ensure that all necessary documentation is provided. This includes evidence that patients were informed of their rights under the No Surprises Act and that any billing complies with the requirements. TSI works closely with our provider partners to gather and validate this information, ensuring compliance and reducing the risk of disputes. Our team also provides training for healthcare providers on how to document compliance with the No Surprises Act effectively.
TSI’s approach to compliance with the No Surprises Act includes leveraging advanced data analytics to verify that all debts meet federal standards before collection begins. Our systems automatically cross-check billed amounts against allowable charges under the law, ensuring compliance and reducing the risk of disputes. This proactive approach protects both consumers and our clients from the legal and reputational risks associated with non-compliance. Furthermore, our commitment to transparency means that we provide clear, easy-to-understand explanations to consumers about their debts, enhancing trust and improving the likelihood of successful collections.
Conclusion
The upcoming CFPB regulatory changes are significant, and preparedness is key. Through this blog series, we aim to educate our clients and prospects about the importance of debt validation and how to navigate these changes smoothly. TSI is committed to staying at the forefront of compliance and helping you adapt, reduce administrative burdens, and continue generating revenue while protecting your reputation.
If you’re seeking a partner with the expertise, tools, and support to meet the new CFPB regulations, TSI is ready to assist. Reach out to learn more about how we can help you achieve compliance and enhance your collection processes. You can contact me at 863-698-9769 or justine.mathews@tsico.com.
