rbordes
Contributor
I recently started working at a Path Lab and for UHC, BCBS, and Aetna, I was asked to stamp the Path reports with a certain stamp "ABC Pathologists", for only those three payers and sent to this other company to bill. I asked why and was told, we were not In Network, and where we are sending them to be billed has a great contract and gets a high reimbursement, so we send those to them to bill, and we client bill them a flat fee. My question is, isn't that "redirecting claims to be paid". I asked about all the other payers, and they said, no we just bill them and if we are OON we just write them off. Something does not sit right with me on this.... because some of our Dr. have become in network and we still send to them to this other company, because we get more $$ by doing this.