DESCRIPTION OF THE ISSUE
Claims of non-participating carriers of Dr. were processed as out-of-network deductibles and the responsibilities were forwarded to patients. This frustrated most of the patients and returned us calls for explanation.
CONCEPT
Providers’ participation issue should not worry patients as they are enrolled properly with the plans and pay their
premiums correctly. In such case it is provider’s responsibility to be enrolled with the carriers.
REASON
Until Dr. ’s enrollments with the concerned carriers were approved, we started filing the claims of non-participating carriers under the name of another Dr
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