Pediatric Coding Alert

Be honest with your patients to ensure a smooth transition.More and more providers are questioning whether moving to an out of network situation with a payer -- or multiple payers -- is best for their practice. Becoming out of network has pros and cons that you'll want to weigh carefully before coming to a decision. If you're considering a move to becoming a non-contracted provider, follow these three steps to set your practice up for success. 1. Evaluate Your Existing Contracts and Patient BaseBefore your practice starts talking about becoming out of network with a payer, you should review your contracts. In addition, you should know how many patients are covered by each payer, and the subsequent decrease in expected bottom line if those patients leave and you cannot easily replace them.There are particular key areas to pay attention to as you go through the contracts, says Melanie Maycock, CCA, a billing [...]