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?
It's still unclear because on one hand you said she's NON contracted..if they "negotiated fees" for that person ok, I understand..(usually they don't but ok ) If that's a negotiated fee for all her patients with Anthem..then she is contracted..I don't understand why they wouldn't have contract? Are you POSITIVE there is no contract? maybe they are telling you what they will pay at the NON contracted rate? Even Still BCBS is not going to honor assignment for a non contracted provider, the patient is going to get the check.Also Michele is right..if the provider is agreeing to "accept assignment" she's agreeing to that fee as payment in full you can't balance bill the patient! you need to call provider relations and find out if there's a contract or not.
Yes.. exactly my point Charlene.Any monies due are going to the patient whether they paid or not..So I'm not sure even why the provider would bill according to their allowable when they are non par..they are losing money
My provider does not want to balance bill, she is afraid that due to the amounts of claims- up to $10,000 per pt per month , that she will lose a lot of her pts.