Hello,
I'm working on a project with a Dermatologists office to standardize process and procedures and have a question for the experts on this message board related to billing and insurance payment.
In the case where the Dr is In-Network for a specific patient, but one of the procedures does not pay as insurance decided "not medically necessary". What is the amount the patient is then billed and responsible for?
1. Billed amount
2. Contracted amount for the procedure code (although not covered for this specific patient)
3. Some other amount
Thanks so much and I really like this forum, I'm new and have been on the website reading posts the last few hours!
Laura