Payments > Insurance Payments

Out of network billing

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wharta:
I have a doctor who does not have contracts with her bcbs. All her pts plans have payment whether in network or out of network so receiving payment will not be the issue.
She accepts assignment and has worked out a fee schedule with anthem on what they will pay her per charge.
Should we be balance billing the pts for the difference between what we charge and the allowed amount- balance bill, or should be be just taking what they pay us and writing of the rest?

Michele:
You should bill the patients for any difference in the amount paid and amount allowed. 

PMRNC:

--- Quote ---I have a doctor who does not have contracts with her bcbs. All her pts plans have payment whether in network or out of network so receiving payment will not be the issue.
She accepts assignment and has worked out a fee schedule with anthem on what they will pay her per charge.
Should we be balance billing the pts for the difference between what we charge and the allowed amount- balance bill, or should be be just taking what they pay us and writing of the rest?
--- End quote ---

I'm confused because NON par providers will not receive the checks, as BCBS will not honor assignment for non contracted providers.

medauthor:
I, too, am confused because if she is "accepting assignment"; by definition, that would mean she is agreeing to accept what the payer pays as payment in full minus any deductible, co-payment, or co-insurance. 

ellie:
what is everyone's definition of balance bill the patient ?

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