i'm not 100% sure on that. I worked at a hospital where the hospital was OON but the provider was in. The hospital charges were processed as OON, but the provider was paid in net. I have also had the reverse. When I went in for a procedure, the hosptial was in net, but the provider was out. From what I know if a provider is within a group, you still put the group npi on box 32a and the individual in 33a Also you can put the individual provider NPI on each detail line. this lets the carrier know that although the "group" itself isn't in network, the individual is a network provider...the claim still should get processed in net and payment made to the group. I will try to find more information or maybe we will get more feedback on this case for u