Out-of-Network, Out of Luck? A Growing Body of Caselaw Addressing…
It’s become a common scenario for medical providers: a provider treats a patient covered by employer-provided health insurance for which the provider is out-of-network, receives an assignment of benefits from the patient and is reimbursed by the benefits plan administrator at a rate much lower than the amount charged, if at all. The provider then embarks upon the often Sisyphean journey of navigating the plan’s lengthy and nebulous appeals process.
It’s become a common scenario for medical providers: a provider treats a patient covered by employer-provided health insurance for which the provider is out-of-network, receives an assignment of benefits from the patient and is reimbursed by the benefits plan administrator at a rate much lower than the amount charged, if at all. The provider then embarks upon the often Sisyphean journey of navigating the plan’s lengthy and nebulous appeals process.
SOURCE: Health Insurance News – Read entire story here.
