Take a proactive approach when dealing with disputes about bundled charges
The constant back and forth between providers and payers when disputing bundled charges is an all-too-common scenario.
"A payer may believe something should be paid in one particular way, and a doctor or hospital may bill it based on something that is more unbundled, and the payer alleges they are trying to double-dip or getting paid twice," says San Francisco attorney Paul DeMuro.
Depending on the nature of the managed care contract, it may define certain payment alternatives either by virtue of a fee schedule that the health plan has, or the provider may define it in terms of what its charge schedule is as amended from time to time, says DeMuro.
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