Customer just asked me this..

Norvax's rates aren't even posted on Norvax....
You're dreaming.... but then, you knew that.
 
It's more rich when your client plays by all the rules - stays in network for a procedure and get whacked with balance billing from a OON ass't surgeon or anesthesiologist.

Of course, there's no way any client can exercise due diligence in these cases.

In my experience these situations are quite common. There are always going to be PARE doctors to deal with:

P=Pathologists
A=Anesthesiologists
R=Radiologists
E=Emergency Room Doctors

aka RAPE doctors, they are seldom, if ever, in-network contracted with the carriers.

However, 99.9% of the time the carrier will review these and pay the claim at in-network % of actual bill, at least for my clients.
 
PARE/RAPE.

I need to remember that.

Like the one I borrowed years ago from a buddy. DAMN coverage.

Drug, alchohol, mental, nervous.
 
In my experience these situations are quite common. There are always going to be PARE doctors to deal with:

P=Pathologists
A=Anesthesiologists
R=Radiologists
E=Emergency Room Doctors

aka RAPE doctors, they are seldom, if ever, in-network contracted with the carriers.

However, 99.9% of the time the carrier will review these and pay the claim at in-network % of actual bill, at least for my clients.

We fought and won on both cases where my client's got balanced billed while at in in-network facility - took a while but we won.
 
And by the way - won another one about a year back. Any have this happen?

Client went to an in-network doctor - about a month later he gets hit with the bill.

Come to find the doctor is "no longer taking that carrier" which seemed to be simply a personal decision on his part - not contractual since I got confirmation from the carrier that he was indeed still contractually an in-network doctor.

Client back on the phone and the doctor simply said he was fed up with the slow pay and decided to to accept that network. Again, he was still under contract.

It almost got ugly but in the end we won. Doctors simply can't wake up one day and decide to violate their contract.
 
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