What are the “seven out-of-network reimbursement policies?”
In addition to the UCR database, the Defendants’ seven out-of-network reimbursement policies resulted in under-reimbursement of payment for out-of-network services. Physicians can therefore file claims for out-of-network services that were processed or reimbursed by a Defendant using the UCR database or one of the seven out-of-network reimbursement policies. The seven out-of-network reimbursement policies are the Defendants’ (1) anesthesia policy; (2) assistant surgeon policy; (3) co-surgeon/team surgeon policy; (4) multiple procedure policy; (5) preventative medicine policy; (6) professional/technical policy; and (7) reduced services policy.
Related Questions
- Are public and private health insurance reimbursement policies barriers to adoption of appropriate technologies? How can these be overcome?
- Where can I find the most up-to-date information on current Travel reimbursement policies? Can I still use the Travel Handbook?
- What are the Expense Reimbursement Policies and Procedures?
