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gderilus:
I have a provider that wants to bill BCBS but she's not in network with them. Can she still see patients and bill Blue Cross/Blue Shield. Would she get pay for her services.

Pay_My_Claims:
she will be paid at the out of network rate, if they have out of network benefits. The rate of pay is considerably less for out of network providers, and also bcbs (of NC) send payments to the clients instead of the provider when you are non-par.

gderilus:
if the patient has copay, do you still collect copay even if you billing out of network or do you get full payment from the insurance company.

NuBiker:
If you have time, go online, and find out how to get the doc to become an in-network provider.
There will be a form for the doc to fill out, as well as a list of all the info she has to submit to them.
It will make your job easier if your doc can become a participating provider.
Another thing, get a list of all the insurances the doc belongs to, and get a login at each of their websites.

Nu

Pay_My_Claims:

--- Quote from: gderilus on January 22, 2010, 09:45:58 PM ---if the patient has copay, do you still collect copay even if you billing out of network or do you get full payment from the insurance company.

--- End quote ---

if you are OON, you can collect 100% of your charge up front, since as an OON provider, you can balance bill the patient. You can then file non-assigned and the client will get whatever the ins company reimburses the claim at. Being OON it is really better to collect up front.

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