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OON provider submitting lab claims

sugihara

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We are a billing service, and most of our providers are out-of-network. Labs will not contract with them, nor will they submit claims to insurance companies, rather they bill the provider directly. Can the provider submit claims for labwork done outside the office? I have heard 1) yes, a provider can submit claims for labwork, and 2) no, the patient must submit claims for labwork when the lab does not.

Any guidelines or rules would be greatly appreciated--this has become a "hot topic" among these providers.

~Kelli S.
 

sugihara

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I am speaking at a national conference on Friday and was hoping to have some sort of answer (I know this question will come up).

Anybody-?

~Kelli Sugihara
 
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