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tci Outpatient Facility Coding Alert - 2018 Issue 1

Reader Question: Get OON Billing Right Every Time

Question: What are some best practices we can follow for compliant out-of-network billing? Ohio Subscriber Answer: If you have compliant policies and procedures in place and you always follow them, you can protect your facility from allegations of improper billing and fraud when billing out-of-network (OON). You'll first want to make sure that you fully disclose your OON status to patients verbally as well as in writing. You'll also want to avoid waivers/fee forgiveness, increased payer charges, and payments to referring physicians. Here are some tips. For waivers, you should: Make reasonable and consistent efforts to collect patient payment...

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