Live Online Classes

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About this program

Master out-of-network (OON) billing. Learn techniques that will help your practice successfully submit and be correctly reimbursed for OON claims. Gain clarification on the rules of out-of-network benefits for beneficiaries. When your billing team knows how to identify and work through reimbursement problems, accurate and complete reimbursement for Out-of-Network billing can be achieved.

Instructor Jan Hailey will clarify the definition of Out-of-Network provider and guide you through the claim submission guidelines, reviewing the most current requirements for proper billing of Out-of-Network claims.

The following key concepts will be addressed and explained:

  • Understand different types of insurance
  • Out-of-network billing options
  • No Surprise Act guidelines
  • Financial Communication
  • Deductibles (in network vs out of network)
  • Out-of-network / self-pay discounts
  • Assignment of benefits vs. Accept assignment
  • Coordination of benefits
  • Prior authorizations
  • Benefit verification
  • Documentation/request for records
  • OON Denials/ rejections
  • The patient experience