Addressing the need for employers, commercial health insurance advisors and brokers, third-party administrators, ASOs and carriers to find clarity and a path forward regarding numerous mandates contained within the No Surprises Act and Transparency in Coverage Rule, TALON has published its Planning Guide, Ensuring Compliance with the No Surprises Act and Transparency in Coverage Rule. The 24-page document offers a comprehensive framework and regulatory literacy that organizations need to make informed technology vendor decisions.
TALON’s Planning Guide is made up of four parts. Part 1 summarizes the impacts of the federal mandates; offers a brief history of the legislation and its goals; and presents key requirements for machine-readable files and the consumer self-service tool. Part 2 breaks down the requirements of the No Surprises Act and Transparency in Coverage Rule, including all requirements covered by TALON; shopping tool and non-shopping tool functionality; and requirements not covered by TALON, but rather by payors, plans, providers, and the government.
Part 3 presents our views on compliance platform selection, including fully scalable, cloud-based, mobile-first technology; eligibility and demographics; plan designs; claims feeds; accumulators; upstream negotiated pricing feeds; payer accuracy; flexible rewards; and describes machine-readable file requirements in greater detail.
Part 4 presents the TALON solution, including detailed descriptions of the platform architecture; innovations; advisory tools; MyMedicalShopper™overview; platform expandability, and more.
To read and download a 3-page Executive Summary of the Planning Guide (also contained within the Guide) please click here.
To register to receive the full Planning Guide, click here.
