Expert needed for Records request

[Char21]

My Psychologist has billed BCBS Advantage and payment was denied for being OON.
Now they are requesting records.  I thought that once payment was denied we do not
have to provide records, has this changed?

[Michele]

I'm not sure if you are the patient, or you work for the psychologist.  Either way, you should determine if the plan has OON benefits.  If they do, that may be why they are requesting the records.  I would first find out if any payment may be made by the records being submitted.  If they aren't going to pay, obviously you don't want to send in the records.  However, if there are OON benefits, then they may require the records to make payment.

[Char21]

Thank you so much, we didn't even think of OON.