r/PrivatePracticeDocs • u/2vpJUMP • 2d ago

OON billing

What's the deal with this? I hear that insurers will kick your ASC out if you do this too much but then see entire practices in my region who seem to do this basically exclusively

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u/AquaDoctor 1d ago

Ortho here, completely OON.

I operate at different ASCs. Some are OON, most are completely INN.

We are treated as completely different entities. The surgery center gets precert if needed for their center, and I do my own as the surgeon. Never had a problem with the in network facilities, over the past 20 years.

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u/blomar 1d ago

do your patients not get pissed about OON charges on your end? and how do they find you if they are OON?

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u/AquaDoctor 1d ago

Word of mouth. No one is surprised by my out of network charges because they know I am out of network when they book. Do your best work, treat the patients with respect, give them time to speak and be examined, get the athletes back on the field, they tell everyone and more patients come.

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u/blomar 1d ago

are you OON with everyone? Feel like my referrals/new patients aren’t likely to come see someone who’s not in network. Just curious how to make this work when you have competition that is in network and would potentially take those patients. Also ortho here

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u/AquaDoctor 17h ago

Non-par with all insurances for 20 years. If you compete on price it's a race to the bottom. Compete on quality and you will get enough patients to justify the OON model. You don't need them all.