We are OON for all ins. except Medicare and accept assignment from the others, and YES we balance bill patients. If patient has no OON I have no choice but to treat them like self pay. If patient has OON, we either: a) charge a copay, similar to an in-network provider b) balance bill for whatever insurance doesn't pay or c) in some cases we'll simply accept whatever the patient's insurance pays. Hope that helps.
James