I work for a Therapists office that bills a lot of out-of-network Insurance companies that have huge Deductibles. For example: We charge $225 for Physical Therapy, the ins allows 56.74, that is applied to the patient deductible. The non-covered portion of 168.26 is considered patient responsibility. We do "accept assignment" on these claims. Here are my questions: (1) Can we collect a flat fee of $75 from this patient and write the remainder off being that we accept assignment for this out-of-network insurance? or (2) If we "do not accept assignment" can we collect a flat fee of $75 from the patient? Thanks for your help!