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Allowed amt too low

  1. Default Allowed amt too low
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    Patient with new private group ins, card says we do not have to be in network to provide services. We billed for OV. The allowed & paid amount (no copay, coins or ded indicated on EOB) is lower than I have ever seen from private ins, just about $1 above Medicaid allowable. Can I bill pt a copay to bring us close to other private ins rates? We have no contract with this insurer.

  2. #2
    if you do not have a contract then you can balance bill the patient up to the charged amount. Unless this private insurance group utilized one of your PPO network contracts

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