Billing > Billing
usuall and customary charges
Michele:
If you are out of network, doesn't the payment go directly to the patient, and you just charge your regular fee schedule? The patient has to pay the whole thing right?
Michele
Pay_My_Claims:
--- Quote from: Michele on July 03, 2009, 02:24:38 PM ---If you are out of network, doesn't the payment go directly to the patient, and you just charge your regular fee schedule? The patient has to pay the whole thing right?
Michele
--- End quote ---
No, not all carriers will pay directly to the client. The one that I know that does that is BCBS-NC even if you file assigned. Other carriers will still pay directly to you, unless you bill non-assigned and collect 100% up front.
PMRNC:
BCBS will not honor assignment of benefits. A few states have taken them on in court over this and lost.
Pay_My_Claims:
--- Quote from: PMRNC on July 03, 2009, 06:08:10 PM ---BCBS will not honor assignment of benefits. A few states have taken them on in court over this and lost.
--- End quote ---
Yes, and thats why I despise BCBS. They used to be my favorite...LOL. I love them as innet providers :-)
Aint i 2faced :o
PMRNC:
Well .. actually I have never had a problem with it. Any of my clients that don't par I have them collect up front.
In EVERY SINGLE BCBS Policy Handbook and EVERY PROVIDER Contract.. they state this.. so it should never be a surprise, if the doctor is NON par with BCBS..the patient SHOULD be aware and the doctor should be prepared to collect up front. They also have an automated disclaimer when you verify benefits.
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