The physician I am billing for does not have cotract with United Health or Blue Cross, when I received the EOB, it has an allowed amount which is half of what the physician charge, with a note "This is the amount in excess of the allowed expense for a non-participating provider. The Health Plan is not responsible for any amounts in excess of this allowed expense. So can I charge the rest of the balance to the patient? or can I negotiate to get a high amount from the insurance company? Thank you so much any input.
Just a couple of questions, since you are non-par providers, do you inform the patient first? If you already know you are non-par do you get the patients to sign a waiver? What can save you from determining what you have to adjust off is obtaining payment in full from the patient and filing the claim non-assigned. This will allow payment directly to your client as reimbursement from their policy.
I read Steve's reply on BC Advantage as well, and we can't answer completely yes or no, not knowing the product. UHC has its hands in everything in NC.
Good Blessings
