Billing > Billing

OON provider within In network practice

(1/2) > >>

lotus921v:
Obviously out of network providers can bill higher rates that in network providers... If i were to go to perform work with an in network provider while remaining out of network, what difficulties with billing might i see?

PMRNC:
It's very simple...  In network:  fee schedule.. Out of Network is subject ot U&C / R&C

lotus921v:
U&c r&c?  Whats that?

PMRNC:
U&C is Usual & Customary and R&C means same thing it's just called Reasonable and Customary.

DMK:
It's also important to note that the provider (in or out of network) can CHARGE whatever they want.  That doesn't mean they'll get it.  The fee schedule is set PER insurance company (and all will be different amounts) and U&C is determined by the area the doctor practices in (San Francisco would have a higher U&C than Modesto because the cost of doing business is different).

Navigation

[0] Message Index

[#] Next page