No Surprises Act: How a Clinic Avoided $500k in Penalties

The Problem

Under the NSA, 1 in 3 out-of-network claims face $10k/claim fines for:

• Missing Good Faith Estimates (GFEs).
• Incorrect IDR documentation.

The Fix

1. GFE Templates: Customize for 200+ services.
2. IDR Packets: Include median in-network rates + patient consent.

Case Study

Clinic: Austin Ortho

Result: Avoided $500k in penalties with compliant workflows.

Next Edition Teaser

?? “Medicare Advantage’s 8% Denial Rate: How to Fight Back.”

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