Payments > Insurance Payments

EOB'S

(1/3) > >>

ellie:
We bill for a Dermatologist for the facility. Patient's pay up front. Not sure yet what they are paying for the facility charge ( still trying to determine this )

We bill the insurance company as a courtesy for the patient. Patient's receive check from the insurance carrier

!!!!!!! Isn't the doctor losing money ?????????

He is not contracted with any carriers as of yet.

What would be the reason that the office does not have any copies of any EOB's ?? Have only gotten one EOB.

Out of Network ? Michelle I would really like to talk to you if I could.

Thank you

PMRNC:
There are many practices who do NOT want the hassle of insurance billing.. and I think with Obamacare we are going to find more of them popping up.
Are they losing money? Maybe, but you would need to check with all the carriers and determine and analyze fee schedules. Certainly participating with some carriers means an increase in allowable's (higher fee schedules) but then you don't have the costs associated with patient billing for chasing down deductibles, copay's.  So maybe it just works out for some practices. A lot of homework will have to be done to really see if the practice will do better financially.   I'm a firm believer that if it aint broke, don't fix it.

If I think a provider will be better for getting into panel's I will first do the research and then present to the provider. But like I said, there's usually a good reason they don't want to deal with the insurance. I've seen many practices BETTER off this way.

 

medauthor:

--- Quote ---Michelle I would really like to talk to you if I could.


--- End quote ---

Me? or the site owner, Michele?   ;D

medauthor:
I don't think the doc is losing money if the patients are paying up front; he gets his full price and then the patients are reimbursed whatever----if it's applied to their deductible....if they only get a %...whatever.....he still gets his full price...right??

Pay_My_Claims:
@ Rimmer, true. We do a lot of up-front and billing non-assigned for patients. They sign the disclaimer etc. The only reason he would need the EOB is to really evaluate if his fee is too low. If the insurance company is paying 100% of what he billed, his fee schedule is probably too low and needs to be reviewed, but I highly doubt that.

Navigation

[0] Message Index

[#] Next page