New solutions and its NSA Knowledge Hub address entire lifecycle of a surprise bill for healthcare payors to achieve compliance with No Surprises Act
Dec. 15, 2021 – MultiPlan Corporation (NYSE:MPLN), a leading provider of data analytics and technology-enabled cost management, and payment and revenue integrity solutions to the U.S. healthcare industry, announces its new end-to-end Surprise Billing Service to help healthcare payors comply with the soon to be implemented No Surprises Act. With new requirements set to take effect on January 1, 2022, MultiPlan is prepared to help its customers navigate new regulations with the launch of its No Surprises Act Knowledge Hub, a comprehensive resource center that offers the latest NSA developments and answers frequently asked questions.
MultiPlan’s end-to-end Surprise Billing Service gives healthcare payors easy-to-implement solutions to help comply with new regulations. Building on its existing services and expertise, MultiPlan’s end-to-end service addresses the entire lifecycle of a surprise bill, from identifying surprise bills to managing claims through arbitration:
- Identify Surprise Bills: MultiPlan examines billing codes, facility network status and episodes of care for payors’ networks and its own to identify surprise bills.
- Calculate and Append QPA: MultiPlan calculates the Qualifying Payment Amount (QPA) and includes it on processed claims, making it easy to complete the claim adjudication process.
- Price and Edit Claims: MultiPlan can reprice and edit claims using any combination of its services to determine a fair out-of-network amount that providers are likely to accept.
- Negotiate Settlements: Providers that do not accept the initial payment will contact MultiPlan to start the negotiation process. We leverage technology, data, and experienced staff to negotiate a settlement.
- Arbitrate: When settlement isn’t reached, MultiPlan can manage the Independent Dispute Resolution process from start to finish. In determining a final offer, MultiPlan can analyze data from millions of claims, actual facility costs, and more to achieve the best outcome.
MultiPlan can administer the entire process or work with clients to customize a solution based on their specific needs, giving payors the flexibility they need to comply.
“The new requirements of the No Surprises Act are fast approaching, and having a significant operational impact on healthcare payors and providers,” said Dale White, MultiPlan President, Chief Operating Officer. “While the law adds a new level of complexity to paying healthcare claims, the fundamentals are not new to us. MultiPlan has been supporting clients with many of these services for years. With expertise in every step of the process, we can administer the entire No Surprises Act process on our clients’ behalf or customize solutions for their specific needs to drive compliance.”
“With the rules written, we are moving toward enforcement, without much time for the industry to absorb, let alone implement changes to comply with the new regulations,” said Colleen Dempewolf, MultiPlan Director, Strategic Product Development. “Our experts have been closely tracking all aspects of the law to help our customers navigate the changes and to develop solutions that make it easy for them to comply. We know they are facing enormous pressure to adapt to these, and other regulatory changes set to take effect simultaneously at the start of the new year and hope to lessen that burden with trusted solutions and expertise they can rely on.”
MultiPlan’s announcement today continues the Company’s proactive response to the No Surprises Act and builds on steps it is taking to help healthcare payors navigate an increasingly complex regulatory environment, including:
- No Surprises Act Knowledge Hub: As some requirements of the No Surprises Act take effect in January, now is the time for the industry to finalize plans for compliance. MultiPlan’s new No Surprises Act Knowledge Hub is designed to help healthcare organizations navigate the new regulations with answers to frequently asked questions and an overview of solutions.
- No Surprises Act Webinar Series: MultiPlan has also hosted a comprehensive webinar series for clients to explain the law, its implications, and what healthcare payors need to do to prepare for its implementation. With experts from a leading law firm, the webinar series provides an in-depth overview of the No Surprises Act, the Independent Dispute Resolution Process, the external review process, disclosure requirements, and enforcement provisions.
MultiPlan is well-positioned to help customers comply with the new rules and regulations of the No Surprises Act in advance of the required deadlines. Using a combination of existing and new services, MultiPlan customers can reduce the occurrence of surprise bills, and be prepared to strategically negotiate reimbursements when they do occur. For additional information about MultiPlan’s surprise billing and transparency solutions, please visit their Knowledge Hub.
This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act, and Section 21E of the Securities Exchange Act of 1934, as amended. These statements often include words such as “anticipate,” “expect,” “suggest,” “plan,” “believe,” “intend,” “project,” “forecast,” “estimates,” “targets,” “projections,” “should,” “could,” “would,” “may,” “might,” “will,” and other similar expressions relating to MultiPlan’s response to the No Surprise Act, including its end-to-end Surprise Billing Service. Although the Company believes that these forward-looking statements are based on reasonable assumptions at the time they are made, you should be aware that many factors could affect such forward-looking statements. Such forward-looking statements are based on current expectations that are subject to known and unknown risks and uncertainties.
Factors that may impact such forward-looking statements include the factors discussed under “Risk Factors” in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2020 and the Company’s Quarterly Reports on Form 10-Q for the quarterly periods ended March 31, 2021, June 30, 2021 and September 30, 2021, as such risk factors may be updated from time to time in the Company’s periodic and other filings with the SEC. The Company’s periodic and other filings are accessible on the SEC’s website at www.sec.gov. You should not rely upon forward-looking statements as predictions of future events. Although the Company believes that the expectations reflected in the forward-looking statements are reasonable, the Company cannot guarantee that the future results, levels of activity, performance and events and circumstances reflected in the forward-looking statements will be achieved or occur. Except as required by applicable law, the Company undertakes no obligation to update publicly any forward-looking statements for any reason after the date of this news release to conform these statements to actual results or to changes in our expectations.
MultiPlan is committed to helping healthcare payors manage the cost of care, improve their competitiveness and inspire positive change. Leveraging sophisticated technology, data analytics and a team rich with industry experience, MultiPlan interprets clients’ needs and customizes innovative solutions that combine its payment and revenue integrity, network-based and analytics-based services. MultiPlan is a trusted partner to over 700 healthcare payors in the commercial health, government and property and casualty markets. For more information, visit www.multiplan.com.