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"No Surprises Act" Impact on Radiologists


The No Surprises Act (NSA) was signed into law in December 2020, and it has had a significant impact on radiologists. The NSA prohibits balance billing for out-of-network (OON) services received at in-network facilities, and it also requires OON providers to provide good faith estimates of their services.


For radiologists, the NSA means that they can no longer bill patients for more than the in-network rate for their services. This is a major change, as OON radiologists were previously able to charge patients significantly more than what their insurance would cover. The NSA also means that radiologists must now provide good faith estimates of their services to patients, which can help to prevent surprise bills.


The NSA has been welcomed by patients, as it has helped to protect them from surprise medical bills. However, the NSA has also had some challenges for radiologists. For example, the qualified payment amount (QPA) that is used to determine the in-network rate for OON services can be difficult to calculate. Additionally, the NSA has created a new dispute resolution process that can be time-consuming and expensive.


Overall, the NSA has had a significant impact on radiologists. The law has helped to protect patients from surprise medical bills, but it has also created some challenges for radiologists. Radiologists will need to adapt to the new law in order to continue providing high-quality care to their patients.


Here are some specific implications of the NSA for radiologists:

  • No more balance billing. Under the NSA, OON radiologists can no longer bill patients for more than the in-network rate for their services. This means that patients will no longer be surprised by large medical bills after receiving care from an OON radiologist.

  • Good faith estimates required. The NSA requires OON providers to provide good faith estimates of their services to patients. This means that patients will be able to get an idea of how much they will owe before they receive care.

  • New dispute resolution process. The NSA creates a new dispute resolution process for OON payment disputes. This process is designed to be fair to both patients and providers.

The NSA is a complex law, and there are still some unanswered questions about how it will be implemented. However, the law has the potential to make a significant positive impact on patients and radiologists.

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