If you are an out of network Provider submitting Claims on a Client's behalf this article will show you how to configure the Client's account properly.
When you setup the Client's Insurance in their Bill To & Insurance Info tab, you will select NO for both Accept Assignment and Authorize Payment to Provider.
- Accepting Assignment indicates that you are accepting the Insurance Companies contract rates as payment in full. If you are contracted with an Insurance Company you must select Yes. When you are out of network you have the choice the accept or not accept assignment.
- Authorize Payment to Provider indicates where the payment should be sent. Choosing Yes means that the payment should go directly to you. If the Client has already paid you in full and you are submitting to their Insurance as a courtesy you will select No so the Client is reimbursed directly.
NOTE: If you are submitting to an out of network insurance for the first time, they may require you mail or fax a W-9 before they will process the claim. Be sure to check with the payer on their requirements before submitting claims to avoid a delay in payment.
Setup Client Insurance for Out of Network Claim Submissions
- Locate Client and open Client Profile.
- Click Bill To & Insurance Info in side menu.
- Scroll to bottom and click Add New Insurance button.
- Enter the Client's Policy information.
- For Accept Assignment, select No.
- For Authorize Payment to Provider, select No.
- Scroll up and click Save.
Related Articles: Submit Claims that have been marked as Fully Paid