Wiki Contracted facility & non-contracted provider

[Coder.Melisa]

My question is about contracted faclilties and non-contracted providers. If claims are applied to the PT out of network benefits can't this be disputed as the facility was a contracted facility? Shouldnt the claim be processed as in-network due to the facility being contracted?

Any feedback would be greatly appreciated

 

[miracle01]

IN/OUT network

The facility claim would process as in network, the physician's claim would process out of network.