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Gastroenterology Coding Alert

Practice Management Tips:

Follow These 3 Expert Tips to Ease Out of Network Pay

Published on Sun Nov 25, 2012

Keep patients in the loop regarding out-of-pocket expenses. If your gastroenterology practice is planning on shifting to be a non-contracted provider, try these three field-tested tips to enjoy a smooth transition to being out of network. 1. Evaluate Your Existing Contracts and Patient Base Before your practice starts talking about becoming out of network with a payer, you should review your contracts. There are particular key areas to pay attention to as you go through the contracts, says Melanie Maycock, CCA, a billing consultant from Abrahams Medical Consulting in Romulus, Mich.   According to Maycock, you'll want to look for the following things: Enhanced groupers   Implant thresholds   Procedure rates versus case rates   Silent PPOs   Reduction of state mandated fee schedules   Claims filing limitations   Penalty for provider termination.   You also want to determine how going out of network will affect your patients and, as a result, [...]
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