Thursday, May 19, 2022

Re non-par provider

Joyce Perrone

We actually were just having a discussion of par/ non-par w/ Medicare
and having a contract with a private insurance carrier. You were correct
in your statement. Since you don’t have the option once you have a
contract of picking an choosing what you will/ will not accept, you
cannot do a non-assigned claim and then balance bill, etc. Most
contracts have VERY CLEAR language about this.

NOW – you can bill for non-covered items and we usually collect for
these items upfront. BE SURE you have them sign a form that states you
have informed them upfront of the costs. Have the patient sign, copy in
chart, etc. Some companies demand that you do this, but I believe it is
good practice and good proof regardless. Do not use the ABN as this is
for MEDICARE – but you can morph it into a simple non-covered services
form.

Again -be sure you read and totally understand what you accepted in the
contracts you sign!

Joyce J. Perrone
De La Torre O&P, Inc and Promise Consulting
300 Alpha Drive Pittsburgh PA 15238
ph: 412-599-1112 fax: 412-599-1130
ORIGINAL POST: Date: Wed, 20 Apr 2005 09:39:46 -0400
From: Bolandpocenter
Subject: Non Participating provider

I know we can be non-par with Medicare, but we had heard there is no =
such thing as a nonassigned claim when you have a contract with a =
private insrance such as Secure Health or maybe BCBS? =20

Any feedback?

Stephanie Nauss
BPOC

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