No Surprises Act Takes Effect Jan. 1

The federal No Surprises Act takes effect Jan. 1, 2022, and seeks to protect consumers for surprise medical bills. Among its provisions, the No Surprises Act:

  • Protects patients from receiving surprise medical bills resulting from gaps in coverage for emergency services and certain services provided by out-of-network clinicians at in-network facilities, including by air ambulances.
  • Holds patients liable only for their in-network cost-sharing amount, while giving providers and insurers an opportunity to negotiate reimbursement.
  • Allows providers and insurers to access an independent dispute resolution process in the event disputes arise around reimbursement. The legislation does not set a benchmark reimbursement amount.
  • Requires both providers and health plans to assist patients in accessing health care cost information.

Jefferson Community Health & Life is putting into place the required policies and provisions to comply with the act. JCH&L’s information can be found on the website at JCHealthandLife.org, and then under I want to …. View Surprise Billing/Good Faith Estimate Information.

Under the act, when a patient receives emergency care or gets treated by an out-of-network provider at an in-network hospital or surgical center, the patient is protected from surprise billing. Surprise billing may happen when a patient can’t control who is involved in his or her care – such as during an emergency or when a visit is scheduled at an in-network facility but is unexpectedly treated by an out-of-network provider.

The new provisions also allow patients to receive a Good Faith Estimate of the cost of particular medical procedures from health care facilities. Health care providers must provide an estimate of the bill for upcoming medical items and services to patients who don’t have insurance or who are not using insurance to pay for a service. The Good Faith Estimate would be given for the total expected cost of non-emergency items or services. This includes related costs, such as medical tests, prescription drugs, equipment and hospital fees. The Good Faith Estimate is given in writing at least one day before the medical service, or may be given before scheduling. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

If you have questions about these new rules, call JCH&L at 402-729-3351.

Do You Make New Year’s Resolutions?

Do you make New Year’s Resolutions?

Jen Johnson, manager of JCH&L Burkley Fitness Center, said she’s a big fan of people setting goals to improve their health – but not necessarily a fan of New Year’s resolutions.

“When we think about New Year’s resolutions, we tend to think of huge, grand changes that are lofty and hard to achieve, even for the most disciplined people,” Johnson said. “I’m not a big fan of New Year’s resolutions, because in making them we often seem to set ourselves up to give up before we can reach the goal.”

Johnson recommends is that people who set fitness goals start small and set realistic, achievable goals.

She suggests: “Instead of ‘I want to lose 30 pounds,’ start with ‘I want to find a type of fitness I enjoy doing.’ Instead of ‘I am starting a diet,’ take one or two menu items and replace them with something better.  One cup of coffee can be replaced with one glass of water.  One night a week that is usually a pizza night can be a ‘try a new veggie’ night. Instead of ‘I’m going to save up $1,000, start saving $10 per week.’ Smaller, more manageable goals are more fun because you will feel successful, and that snowballs into wanting to set more and more small achievable goals! These will add up and before you even realize it you have found fitness you loved, lost weight, felt better with your new favorite veggie meals and have a little bit more money in the bank.  Let’s start up some good foundational habits and feel better in 2022!”

And don’t feel goals can only be set at the start of a New Year. Goals can be set any time. The Burkley Fitness Center offers a wide variety of ways you can keep fit – cardio and weight equipment, a pool, and many types of classes.

“If you will share with us your fitness goals, we can help you learn the best ways to work toward the goals, and you can try out a wide variety of exercise to find one that you truly enjoy. For some, classes are excellent because they also provide time to socialize with others who are working toward their fitness goals,” Johnson said.