Wiki OON Surgery Centers

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susie59

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Hello,

Our newest surgery center is still out-of-network and will be for approximately another year. Carefirst (BCBS) refuses to send the payments to our facility, but rather; they send the check directly to the patient. Some of these checks can be quite large since they cover the cost of our implants. Does anyone else deal with this, and how are you handling it with your patients? We had this issue several years ago with another one of our facility before they went in-network, and had a lot of patients keep their checks and not turn them over to our facility. Are you having your patients pay upfront? What about procedures that have the high dollar implants, how are you handling this?

Thank you in advance for your response.
 
Boy could we swap stories! LOL.... our center was OON until March of this year, we opened in 2010. So that's 4 years of them sending payments to the patient. We have a letter that we mailed to the patient the moment we obtained status from BCBS stating the payment was mailed to the patient (we would also immediately call the patient). The letter contained how much the BCBS check was and how much their coins/ded/copay would be, if they had not already paid it. We gave the patient 10 days to bring the check in or they would be turned over to collections.

I'm happy to help you with anymore questions!
 
The insurance company I work for used to do that. We found there was a lot of patient fraud so discontinued it. Good luck to you
 
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