Medical Billing Forum

Billing => Facility Billing => : deepu2706 October 22, 2014, 06:32:42 PM

: ASC quiries
: deepu2706 October 22, 2014, 06:32:42 PM
For ASC facility when claim is billed to UHC, will all the claims processed by UHC or its TPA (Viant, Multiplan). This is for state of Texas. Please clarify me with your thoughts. :) :) :) :) :) :) :) :)
: Re: ASC quiries
: coder59 January 22, 2015, 10:18:16 PM
I believe this will depend on whether your facility is in or out of network.  For OON facilities, usually a third party (Viant or MultiPlan) will negotiate the amount.  At our ASC, we always request 80% of the billed amount.  If your facility is in-network, you should already have a contracted reimbursement amount so UHC should make the payment.