Wiki Guidelines for billing the patient for in and out of network providers

[pewilliams]

Does anyone know the guidelines for billing patients if you are an in-network or out-of-network provider?
Can you give the patient a discount, or must you bill them the same amount as the insurance company?

 

[CodingKing]

You have to bill the insurance what you consider payment in full. You have to bill the patient for whatever copay, coinsurance and/or deductible is. For OON the only thing you can choose to write off is the amount over usual and customary. In Network the amount over contract would be a contractual write off. Regardless if In or Out, waiver of coinsurance/copay/deductible can be considered a kickback.