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How UConn Health, Cleveland Clinic Battled the No Surprises Act This Year

Analysis  |  By Amanda Norris  
   December 08, 2022

Revenue cycle leaders at these prominent organizations chatted with HealthLeaders about how they delt with the No Surprises Act implementation this year.

It has been a while since a regulation has shaken the revenue cycle as much as the No Surprises Act has.

As CMS continues to make changes to the various aspects of the No Surprises Act, the struggle to implement changes and adjust processes is far from over.

One of our top stories from 2022 detailed how organizations worked to implement and keep up with changes surrounding the No Surprises Act. As regulations continue to evolve into 2023, their stories are as pertinent as ever.

Karen Kennedy, director, revenue cycle, Cleveland Clinic, Ohio and Florida:

"Our planning and preparation for the ​No Surprises Act (NSA) was led by a cross-functional team including high-functioning caregivers from IT, legal, patient access, billing, self-pay follow-up, and education.

Members of this team meet weekly to create an overall strategy and manageable ongoing process that met all of the additional requirements of the NSA.

Although implementation was complex and resource intensive, Cleveland Clinic fully supports the legislation to protect patients from surprise billing."

Sarah Ginnetti, associate vice president of revenue cycle at UConn Health, Connecticut:

"As a result of preparing for that regulation, we did stand up another cross-functional team in the organization. We found a way to develop some workflows within Epic [and] identify the right team members to assign to some of this work in order to manage and respond to the No Surprises Act.

I think we actually have a pretty good process in place. It is very manual and that's the one thing I don't like about it. But we right now don't have the infrastructure set up around it to make it a more automated process. However, that is part of our roadmap going forward that's tied to the patient experience. [That will include] building out our estimate platform.

For all intents and purposes, we are, I would say, 90-plus percent compliant, and were as of January 1."

“Cleveland Clinic fully supports the legislation to protect patients from surprise billing.”

Amanda Norris is the Revenue Cycle Editor for HealthLeaders.


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