Hi Linda-
They use the same fee schedule for all charges. No matter which insurance payor it is being submitted to.
The question that I need is pertaining to what they can discount their patients at. If they don't have a contract with an insurance carrier, they are going to be reimbursed OON. Can the provider collect an "in network" coinsurance/copay and w.o. the balance as "professional courtesy", "prompt pay", etc?
Also, what about OON "high" deductibles being "overlooked" and just charging for in network deductibles. Basically, the patient is going to the OON provider, but being seen as if in network. What part is/is not legal??
Thanks!