As the rule making process begins by HHS for the Federal Surprise Billing Legislation, lessons learned from Texas and the rather arduous arbitration process:
Allow submission of claims via batch and via upload of excel or some file format. TX. requires data entry on their website of claims, one by one, by one.
Claims should be able to be grouped by the practice NPI and not by each individual MD, again a requirement of TX.
The 835 files should have a designation on each claim line as to whether fully insured or ERISA plan so we know whether we are going under the arbitration rules of the state or Federal level.
Don't recall who's on the leg committee of the RBMA - Barbara maybe??? but keep these items on the agenda.
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Douglas G. Kraus, CPA
Chief Financial Officer
South Texas Radiology Group, P.A.
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