Have you ever wondered why some doctors, hospitals, and other healthcare providers can automatically file claims for you while others you must pay out of pocket or file cumbersome claim forms to get the bill paid? This is the result of health insurance contracts. Healthcare providers contract with certain health insurance companies and agree to accept a discounted fee in exchange for automatic billing and reimbursements. These contracts, often referred to as payer contracts, also include other terms in order for a physician or clinic to become part of a particular health insurance provider's network of physicians.
These payer medical insurance contracts can be quite beneficial to physicians and other healthcare providers. In exchange for accepting a discounted rate, medical professionals and practices gain access to each insurance company's participants. They also benefit by way of a more guaranteed payment system known as assignment of claim. Rather than billing the balance of medical treatment costs to the patient and waiting for payment, invoices for services provided are submitted directly to the insurance company and paid directly to the doctor. This reduces the risk that a patient will file a reimbursement claim with their health insurance, yet not pay the doctor's invoice in full.
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Medical insurance contracts with multiple managed care companies ensures a physician or other medical professional can accept patients from numerous networks, all with a reduced risk of collection accounts for patients who elect not to pay their bills. More secured revenues help a medical practice increase their revenues, even though they are getting paid less in terms of per visit charges. For many practitioners, this guaranteed payment is worth far more than getting top dollar for their services. For patients, this system also assists them with out of pocket expenses and time spent waiting for reimbursements.
Whether your physician files your insurance claims automatically or you file claim yourself can determine how much you must pay at the time of your treatment. For example, if your doctor has health insurance contracts with your insurance provider, you may only have to write a check for your co-pay. However, if your doctor does not have a payer contract with your particular insurance provider, you will often have to pay the entire bill at the time of your appointment, then request reimbursement from your insurer. Naturally, you must pay your required deductible before your insurance company pays out on any claim, no matter if your doctor has a payer contract in place or not. If you need assistance in locating particular coverages at a pre-determined price, we can help save 50% on health insurance.
Health Insurance Contracts - Convenient Claims
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