MAPD PPO Out of Network Surgery, Experiences?

Sep 17, 2015

  1. yorkriver1
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    yorkriver1 Guru

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    Looking for your experiences with clients who have had surgery out of network on MAPD PPO's. Costs are the question. Medicare allowable charges being a limiting factor.

    Looks like the Medicare Allowable Charges would have to exceed just over $33,000 for all the $10K to be used up.

    Have you had clients up to the limit? Issues with balance billing?
     
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