Mitigating Out-of-Network Billing Surprises
Out-of-network (OON) billing is often viewed as a "necessary evil" in healthcare—a way to maintain fair market rates that often ends in a PR nightmare of patient disputes and "surprise" bills. But it doesn't have to be a choice between your revenue and your reputation.
At Healthcare Logic, we believe that transparency is the ultimate safeguard for your bottom line. Transitioning to or maintaining an OON strategy requires more than just high-dollar billing; it requires a proactive patient advocacy protocol. When patients understand their financial responsibility before the service, and when your billing team knows how to negotiate with payers without putting the patient in the middle, disputes vanish and collections rise.
Our OON Excellence Strategy includes:
Pre-Service Financial Counseling: We provide clear, plain-language cost estimates to patients before they ever walk through your doors, setting expectations and building trust.
No Surprises Act Compliance: We navigate the complexities of the No Surprises Act (NSA) and Independent Dispute Resolution (IDR) to ensure you are compliant while still fighting for fair reimbursement.
Payer Negotiation & Gap Exceptions: Our team specialized in securing "GAP exceptions" and single-case agreements, allowing patients to see you at in-network rates while you receive OON-level reimbursement.
Compassionate Collections: We handle OON billing with a "patient-first" lens, offering flexible payment options and clear communication that prevents social media complaints and legal friction.
You provide elite, specialized care that deserves a premium rate. We provide the administrative bridge that ensures you get paid that rate—without compromising the patient experience.
Secure your revenue and your reputation. Discover our proactive OON protocols at https://myhealthcarelogic.com/ambulatory-service-billing/
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