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Lesser-known new changes to No Surprises IDR: Batching, registration

(On Jan. 22, Part B News covered recent rulemaking and changes in the IDR portal and processes -- new administrative fees, information requirements, open negotiation notices, etc. Adding commentary here on futher changes to those processes is Mena R. Francis, counsel in Mandelbaum Barrett PC’s Healthcare Practice Group and head of the Firm’s PIP Arbitration/Reimbursement Recovery Department.)

Another proposed change is the relaxation of batching provisions to facilitate initiating parties’ ability to include multiple related disputed items or services into a single dispute. This would improve efficiency, minimize costs for disputing parties and promote logical and consistent payment determinations. (See "6.1.3. Batched Claims and Bundled Items and Services" in the revised Federal Independent Dispute Resolution (IDR) Process Guidance for Disputing Parties.)

The Final Rule also proposes to establish an IDR registry requiring payers subject to the Federal IDR process to register with the Departments and provide general information on the applicability of the Federal IDR process to items or services covered by the payor. This proposed change would help parties distinguish between different types of coverage (such as distinguishing between insurance coverage offered by an issuer and a group health plan for which an issuer serves as a third-party administrator) and improve information-sharing issues between parties.

For all providers who have harbored skepticism toward the IDR process given its many inefficiencies and shortcomings, the proposed changes, if adopted, should give providers at least some renewed hope in the IDR process.
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