OON payment

Blackhorse

Guru
Messages
147
Location
Irvine, California
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0
We performed many Covid testing for OON patients. I'm wondering is there a fee schedule for OON payment or we just take whatever the payment the payer wants to pay us. The reason I'm asking this question is because we have an Aetna PT had 5 testing with us, we got paid 5 different amount for U0003. I called Aetna a couple times and nobody can explain to me why those payment are different.
 

Sarahlukkarila

Contributor
Messages
10
Best answers
0
I think they honestly just pay whatever they want. There isn’t any fees associated with being out of network that I have seen. I think we are just at the payers mercy being an OON lab
 

Tara0513

Networker
Messages
32
Location
Colts Neck, NJ
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0
My lab is out of network with most insurance companies (just not aetna) but with the other insurance companies we send an UCR-Usual customary rate appeal. Most of the time the insurance company does pay additional. You can try that route!
 
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