Question 1

When must the No Surprises Act become effective for Self-Funded Plans?

Accepted Answer

On the renewal date of the Plan in 2022

Answer

On the Date or Birth of the Member

Answer

01/01/2022

Answer

When the Member is re-enrolled for 2022

Question 2

When can Ancillary Providers balance bill the Patient?

Accepted Answer

Never

Answer

Only after the claim has been denied

Answer

When the Patient has signed a waiver

Answer

When the charges are over the Usual and Customary

Question 3

Emergency Services for OON Providers will be applied to the OON Deductible and Out-Of-Pocket.

Accepted Answer

false

Answer

true

Question 4

When may an OON non-emergency service from an INN facility balance bill?

Accepted Answer

OON non-emergency services may only balance bill when they have obtained the members consent no later than 72 hours before the scheduled procedure.

Answer

Never

Answer

OON non-emergency services may balance bill when the Plan has not paid the allowable amount of the claim/bill.

Answer

OON non-emergency services may balance bill when the (IDR) negotiations are complete.

Question 5

When is an IDR (Independent Dispute Resolution) used?

Accepted Answer

It is uses to resolve a payment issue between the Plan and the Provider

Answer

It is used to resolve a payment issue between a Patient and Provider

Answer

It is used to resolve a payment issue between the Plan and Patient

Answer

It is used to challenge what the Patient owes

Question 6

The member can waive the NSA Protections for balance billing for Ancillary benefits.

Accepted Answer

false

Answer

true

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