We Can Help.
At Cohen Howard, we have been successfully handling a multitude of NJ Surprise Bill claims since it was enacted August 30, 2018. We remain dedicated and ready to help you negotiate and arbitrate these type of claims..
To optimize reimbursements for surprise bill claims, out-of-network providers and practices must be knowledgeable and adept at handling these time sensitive claims including complying with the office procedures and billing processes asserted under the law.
- Did you know that disclosure requirements vary by setting?
- Does your team know what information needs to be shared with the patient prior to the appointment? What information is mandatory at the time of the appointment?
- Is your team knowledgeable about what information needs to be in written form and what can be communicated orally?
- Are you aware that disclosure requirements apply to all plans, not just ones subject to the Surprise Bill?
- Are you ready to negotiate and arbitrate?
We have successfully collected tens of millions of dollars for out-of-network providers working solely on contingency. Under the NJ Surprise Bill law, it is critical to be prepared to timely negotiate and/or arbitrate your claims. Contact us today for a free consultation and learn how we can help set up your practice to maximize reimbursements on your claims.
What You Need To Know About The New Jersey Surprise Bill
On June 1, 2018, Governor Murphy signed the NJ Surprise Bill law (known as the “Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act”). The legislation, in part, was designed to increase transparency of medical billing and to restrict balance billing for certain types of out-of-network procedures: namely ER, Urgent Care and what is referred to as “inadvertent out-of-network services” under State Health Benefit plans and fully-insured plans. As of August 30, 2018, providers are required to adhere to specific disclosure protocols.
Tracking of New Jersey Surprise Bill Claims Submitted for Arbitration
The State of New Jersey’s Department of Banking & Insurance (DOBI) has published key statistics including the number of out-of-network arbitration requests received, the disposition of the requests, and a list of self-insured plans that have ‘opted in’ to the arbitration process — a total of 137 as of January 28, 2021. A few notable businesses that have opted in are listed below. For a full list please access the NJ DOBI’s Out-of-Network Consumer Protections, Data Reporting link . The complete list is in the section Self-Funded Plans.
- Regeneron Pharmaceuticals Inc.
- South Brunswick Board of Education
- Kearney Bank
- Hard Rock Hotel & Casino Atlantic City
- Redfin Corporation
- CentraState Healthcare System
On July 9, 2018 Leslie Howard hosted a live webinar and that outlined the impact of the NJ Surprise Bill for the out-of-network provider community including plans covered, disclosure requirements, dispute resolution and much, much more. See the entire presentation below.