Author Topic: OON Benefit question  (Read 365 times)

surfergirl

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OON Benefit question
« on: April 22, 2022, 05:29:50 PM »
We are OON with a payer. we explain to the patient that as a courtesy to them we will bill their claim to their insurance.  Turns out the patient has OON benefits. We get a check with an allowed amount which is of course less than our fee. Can we still go ahead and collect the total fee or have to honor the EOB with the lesser allowed amount. This has always been confusion to me as a biller. We are OON but the client has OON benefits. What is the correct amount to collect from the patient.
Any thoughts anyone please.

Thank you.

Happy billing!!!!

Michele

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Re: OON Benefit question
« Reply #1 on: April 26, 2022, 01:18:00 PM »
You can still charge your full fee.  Just because they have out of network benefits does not mean you have to accept their allowed amount.
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surfergirl

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Re: OON Benefit question
« Reply #2 on: May 03, 2022, 07:44:16 PM »
Thank you soooooo much

Medical Billing Forum

Re: OON Benefit question
« Reply #2 on: May 03, 2022, 07:44:16 PM »