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Wiki Gap Auth - How to collect

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Brittneybrookebarber

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If a patient has a gap auth are your required to accept the allowed amount for the service or are you able to charge the out of network fee?
 
A network gap exception can be granted by a health plan in order to treat a particular medical service as if it's in-network, even though it's done by an out-of-network provider. These exceptions are considered on a case-by-case basis. They can be granted if there are no in-network providers within a reasonable distance/time who can provide the care that the patient needs in a timely manner.
 
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