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Thread: Out of Network Payment To Patient

  1. #11
    Join Date
    Apr 2007
    lauderdale lakes


    AAPC: Back to School
    I have OON doctors in NY and the patients do keep the checks. I make a call to them about getting the checks sent in. If that doesnt work and they do not pay, as well as sending them to collections, I send a letter than explains that I will be contacting the insurance co and asking them to issue the pt a 1099 so they can report it to the IRS as income. I then fill out a form for the IRS asking them to check that this income was actually reported. If the scare of an IRS audit doesnt make them pay... nothing will.

    I do have a good collections company that I use. I have sent them high balances and have had no issues. If you email your info, I can have the account manager call you. If its a referral from another dr, they may give you better rates.


  2. #12


    I would also research different collection agencies, some collection agencies are pretty agressive and will take these patients to court for you for a part of the payment received. Also, when scheduling these patients for surgery or when you see them in follow up you may want to offer something like what you may for self pay patients. That if they pay or forward the check to you immediately you will accept what the insurance pays minus any copay or deductible, If they do not, they will be responsible for the full amount of the bill.

  3. #13
    Join Date
    Apr 2007
    Woodbridge, VA


    One of the things we do if we know we don't participate with a particular insurance, is to collect payment up front from the patient. We then hand them a detailed receipt with codes so they can submit on their own.

    Zaida V Aquino, CPC

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