Understanding the No Surprises Act Rollout and In-Network Claims Surge

No surprise act, box with question mark?

In a world where healthcare costs and billing practices can often feel overwhelming and complicated, the rollout of the No Surprises Act represents a significant step towards transparency and consumer protection.

Recent data from FAIR Health (an independent nonprofit organization focused on healthcare data) has shed light on a trend coinciding with the implementation of the No Surprises Act: an uptick in in-network claims. Let’s dive into what this trend means and how it may help you make informed decisions about your healthcare.

The No Surprises Act: A Brief Overview

Enacted in December 2020 and implemented in January 2022, the No Surprises Act aims to protect patients from unexpected medical bills resulting from out-of-network care. The legislation requires providers, facilities, and insurers to adhere to specific guidelines regarding billing practices. Essentially, the act attempts to eradicate “surprises” on a medical bill and make sure patients are never unknowingly receiving costly out-of-network care.

FAIR Health’s Findings

According to FAIR Health, the rollout of the No Surprises Act coincided with a notable increase in in-network claims. This surge suggests the legislation is having a tangible impact on patients’ access to and utilization of in-network providers and services. Here are some of the key factors driving the surge:

  1. Enhanced Consumer Awareness: The No Surprises Act has heightened the importance of seeking care from in-network providers. This will help to avoid unexpected medical bills.
  2. Insurer and Provider Compliance: Insurers and healthcare providers are increasingly aligning with the requirements to ensure compliance and avoid penalties.
  3. Improved Transparency: The legislation has spurred greater transparency regarding healthcare costs and coverage. This will enable patients to make more informed decisions about their care.

Benefits for Consumers

But how does this affect you? The increase in in-network claims offers several benefits for consumers, including:

  1. Reduced Financial Risk: Patients can mitigate the risk of receiving surprise bills by more easily seeking care from in-network providers. No more unexpected out-of-network costs.
  2. Enhanced Predictability: Patients can budget more effectively as in-network services provide greater predictability regarding healthcare costs and coverage.
  3. Improved Access to Care: The No Surprises Act promotes broader access to in-network providers. Ensures patients can receive timely and affordable care at lower out-of-pocket costs.


The rollout of the No Surprises Act has ushered in a new era of transparency and consumer protection in healthcare billing. FAIR Health’s findings shows the surge in in-network claims reflects a positive shift towards greater awareness and adherence to in-network care standards.

For more information on price transparency and other health information, please visit our blog.

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