AAPC - Back to school
Results 1 to 2 of 2

Thread: Allowed amt too low

  1. #1

    Default Allowed amt too low

    AAPC: Back to School
    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
    Join Date
    Apr 2007


    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

Similar Threads

  1. Billing for pterygium excision with Ambio5 AMT
    By jstevens28 in forum Ophthalmology/Optometry
    Replies: 1
    Last Post: 03-12-2015, 10:21 AM
  2. Amt/Complexity of data reviewed in MDM
    By lrosselli in forum E/M
    Replies: 2
    Last Post: 01-02-2013, 07:26 PM
  3. Nasogastric Corpak feeding tube w/ AMT septal bridle
    By Shay2025 in forum Gastroenterology
    Replies: 0
    Last Post: 08-13-2012, 07:45 AM
  4. Medicare disallowed amt
    By ladiesnoopy in forum Billing/Reimbursement
    Replies: 1
    Last Post: 02-04-2011, 07:10 AM
  5. Medicare disalloed amt
    By ladiesnoopy in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 02-03-2011, 01:25 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.