Payment challenges for out-of-network providers
Out-of-network providers often struggle on two levels to collect payment. First, the amount of money providers actually receive is an issue because sometimes the payer tries to pay using an alternate fee schedule instead of your billed charges. Second, providers often have a difficult time getting paid directly because many payments are instead sent directly to patients. In addition, some payers try to establish a usual, customary, and reasonable fee schedule to represent the prevalent price in that market for a specific service by which they pay out-of-network providers. This is another way payers try to avoid paying billed charges.
- Senators Hear How Two-Midnight Rule Harms Patients, Hospitals
- 3 Management Lessons from a Supermarket Debacle
- Medicare Advantage Carriers See 'No Choice' But to Accept Cuts
- Handshaking Spreads Germs. Get Over It.
- Healthcare Costs Start With What We Eat
- IOM Identifies GME Problems, Calls for Finance Changes
- Revenue Cycles Get a Boost from Simple JPEG Files
- Hospitals Likely to Outsource ICD-10 at Launch
- Physicians to Appeal 'Docs v. Glocks' Ruling in FL
- Anatomy of 3 Health System Rebranding Efforts