Rachel, I believe that the hard line physicians are beginning to take re: "courtesy billing" a patient's (non-par) insurance reflects just how labor-intensive that process can be. I initiated the very same policy in my office over a year ago. There is no question that patients like the doctor to do the insurance billing and that doctors like doing what makes patients happy... if it's not ridiculously expensive. If TCS standards and a payor-ID/address registry succeed in making this "easy" again, I would expect providers to ease back into doing all the billing for par and non-par plans.
With regard to the work of this group, however, I do not foresee any special challenges or requirements for enabling a non-par provider to track down the CPP requirements for the payor. If the payor requires special handling/routing for claims from non-par providers, that should be reflected in his CPP. -Chris At 02:48 PM 6/29/02 -0500, Rachel Foerster wrote: >The question that leapt into my mind as I read this Payment Policy is that >this provider is clearly stating it will not file claims on behalf of the >patient to a health plan with which it does not participate. Is this the >common practice today? If yes, will this continue to be the common practice >into the future and for how long? If yes, then is the issue of >identification/routing of transactions to payers from non-par/out-of-network >providers one that should require a lot of analysis/discussion, but rather >be put in a "parking lot" for future work effort? Christopher J. Feahr, OD http://visiondatastandard.org [EMAIL PROTECTED] Cell/Pager: 707-529-2268 discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
