Arbitration Services

The No Surprises Act, introduced to shield patients from unexpected medical expenses, brought significant changes to the healthcare landscape. While the act effectively reduced the prevalence of surprise billing, it also posed new challenges for medical providers.

These included heightened administrative demands and complexities in resolving payment disputes. Among the most pressing concerns was the transparency surrounding calculations like the Qualified Payment Amount (QPA), which directly impact reimbursement rates.

Nonetheless, the act has played a key role in streamlining payment disputes between out-of-network providers and insurers, alleviating financial uncertainty for many providers. At Medsol, we embraced the No Surprises Act from its very inception on January 1, 2022.

Within two months, we successfully arbitrated our first Maximus NJ cases, even as others continued to rely on balance billing, unaware of the legal changes. Today, we proudly arbitrate an impressive average of 5,000 claims annually between Maximus NJ and various Federal IDR entities.