No Surprises Act
Effective January 1, 2022, the No Surprises Act provides protections against surprise billing, or balance billing, under medical plans, such as those offered by Sprinklr. This legislation prohibits medical providers from sending surprise bills for most emergency and some non-emergency out-of-network care. For example, if you visit an in-network facility for emergency services, and you see an out-of-network specialist, such as an anesthesiologist, the No Surprises Act now will protect you from out-of-network charges and balance bills for these services.
Transparency in Coverage Act
Effective July, 1, 2022, the Transparency in Coverage Act requires group health plans to provide publicly available machine-readable files that include in-network negotiated payment rates and historical out-of-network charges for covered items and services, including prescriptions drugs. This rule is designed to help patients know how much their health care will cost in advance of treatment.
Starting July 1, 2022, you can access these files by going to:
- Cigna: www.cigna.com/legal/compliance/machine-readable-files
- Kaiser Permanente: www.kp.org
Note: This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
Other steps you can take to save money on health care
- Go in-network for care. Stay in-network to keep all your health care costs as low as possible, including physical, mental health, and related lab work and/or testing.
- Know where to go for care. When you need immediate medical care (that is NOT an emergency) and your doctor isn’t available, you have different alternatives to the emergency room that provide quality care, save time and cost less. Consider urgent care centers and telehealth (telephone or video appointments with a doctor, psychologist or therapist from your home or work).
- Pay less for prescriptions. You can save money on the medications you take by using generic drugs when possible and using a network pharmacy.