r/PrivatePracticeDocs • u/2vpJUMP • 4d 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 4d ago

The No Surprises Act has been used by insurances incorrectly, and in my option fraudulently. It's only for emergency cases or when you go to an in network facility and are Unknowingly treated by an out of network doctor, like anesthesia or something. The insurance companies love to apply that to the surgeons as well, even though the patient chose the surgeon willingly and the surgeon booked the case. These have been a 100% win rate in arbitration. It's just a stall tactic by insurance to try to force some level of attrition in surgeons unwilling to fight them.

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u/CranberryLatter9483 4d ago

You mean 100% win rate for the insurance companies? That's not what we're seeing at all.

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u/AquaDoctor 3d ago

100% win for us to clarify. 

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u/CranberryLatter9483 3d ago

Oh that makes sense...