For my pediatric practices and high dollar claims I have our office manager send a request for Pre-D (Pre determination of Benefits) to the carrier if we are NON par. The pre-d specifies the CPT code, diagnosis and date of service (scheduled). The carrier usually sends back simple letter back with YES or NO the fee is within R&C or U&C. They don't tell you (not legally allowed) the R&C amount otherwise doctors would bill up to that amount which is fraud. We do this with carriers non par with because we can setup a payment schedule with the patient. If the fee is to be cut substantially the provider can decide to write off all or part of the fee that is OVER the R&C. For those we have the patient sign a hardship financial.. just to Cover their butts.