Need assistance with Out of Network billing policy

micki127

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145
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Derry
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Hi,

Can you please assist with how your office handles Out of Network claims? Do you see OON patients? Do you have a billing policy in place for OON claims? What do you do with your denials? Patient/provider liable? Do you have patient's pay the allowable or the full charge? Need advice please.

Thank you,
Micki
 
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6
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We tell OON patients that they have to be self-pay if they want to be seen except in the case where they have OON benefits then we leave it up to the patient whether they want us to bill their insurance or come in as self-pay. Either way, we collect up front or they cannot be seen.

If we receive a denial, then we charge what the EOB states. Most of them apply the full amount to the patient.
 
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