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Hospitalist out of network

  1. Default Hospitalist out of network
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    I'm hoping someone can help me about a debate at my job.

    We are out of network hospitalists group &
    some say since patient is seen in hospital, then we should get paid in network ( which I know is not true, since we have no contract with insurance)
    others say since we are out of network, we can bill patient the balance.

    I need to find somewhere in writing so I can explain to staff. Can someone provide me with rules/laws in florida to when we can balance bill patients.

    Thank you

  2. #2
    Medical Billing
    Florida has anti balance billing laws it would apply to out of network Hospitalists if the service was performed at in network hospital.
    CRC (2018), CPC-P-A (2016), COC-A (2016), CPC-A (2015), PAHM (2010)
    Contract/Fee Specialist - Remote

    20 years health insurance experience: Audit, Claims, Customer Service, Payment Policy, Provider Relations, and Reimbursement

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