As 2021 draws to a close, transparency is one of the biggest conversations for health payers. In 2022, some requirements of the No Surprises Act and Transparency in Coverage Rule come into effect. As payers prepare to meet regulatory deadlines – both near term and those further out – it’s understandable that they might have questions they need to be answered.
Both of these regulations are broad and far-reaching and will have an impact on overall healthcare costs, as well as the contracted rates for payers. In addition, while many payers have already invested a significant amount of money for meeting these mandates, there’s much more that can be done today.
These were the key themes of this Future Healthcare Today podcast, titled, “Transparency in Coverage: Helping Health Payers Understand the Final Rule,” with Dennis Charland, SVP of Sales at Sapphire Digital, which was recently acquired by Zelis.
Charland has previous sales experience at Blue Cross Blue Shield of Massachusetts, and provided a closer look at what Transparency in Coverage means for payers, and explored solutions that can help ensure compliance for both upcoming mandates.
“This convergence of these two pieces of regulations are broad and far-reaching, and have implementation dates that are coming up quickly,” said Charland. “Payers are paying millions of dollars to get up to compliance and it is a significant lift and effort. Every aspect of the regulation is where Sapphire can help, and we have a modular solution that can support the places that payers need help. We can also help translate the regulations into something that will differentiate the member experience.”
Listen to the full podcast below: