{"id":17117,"date":"2017-10-31T09:00:00","date_gmt":"2017-10-31T13:00:00","guid":{"rendered":"https:\/\/www.zocdoc.com\/about\/?p=17117"},"modified":"2023-10-30T13:55:31","modified_gmt":"2023-10-30T18:55:31","slug":"patient-out-of-network","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/","title":{"rendered":"What to Do When You’ve Discovered a Patient is Out-of-Network"},"content":{"rendered":"

It\u2019s not something that happens often, but despite intake process and office procedures, sometimes you may discover a patient is out-of-network after you’ve completed the appointment.<\/p>\n

Healthcare is complicated and patients don\u2019t always understand their coverage<\/a>. A 2013 study published in the Journal of Health Economics<\/a> found only 14 percent of consumers with private health insurance had an accurate understanding of the terms deductible<\/em>, copay<\/em>, co-insurance<\/em> and out-of-pocket maximum<\/em>.<\/p>\n

Nevertheless, there are ways to navigate the situation, and more importantly, prevent this problem from happening in the future.<\/p>\n

1. Submit the claim<\/h2>\n

Depending on the type of coverage, the insurance company may pay a portion of the bill so always submit the claim in case.<\/p>\n

2. Negotiate<\/h2>\n

When the insurance company makes their final decision, you can negotiate a payment plan with the patient or ask the patient to pay a portion for your time.<\/p>\n

3. Request payment upfront<\/h2>\n

To avoid seeing an out-of-network patient, ask for full payment upfront. In fact, approximately 75 percent<\/a> of healthcare and hospital systems practice point-of-service collections, or the practice of requesting payment when services are rendered, according to Richard Gundling, senior vice president at the Healthcare Financial Management Association.<\/p>\n

4. Always confirm coverage before the appointment.<\/h2>\n

Since policies are constantly changing, ask your staff to verify insurance coverage for both new and existing patients when appointments are made.<\/p>\n

Insurance Checker<\/a>\u00a0helps speed up this process. With Insurance Checker,\u00a0patients can decipher their insurance card, select the right insurance plan and get verified plan details before they book.\u00a0Patients simply scan their insurance cards, see their real plan names, confirm their eligibility status and in many cases, their deductibles and co-pays as well.<\/p>\n

5. Give patients the billing policy
\n<\/strong><\/h2>\n

Before the appointment, ask your office staff to email patients your financial procedures and remind them to bring their insurance cards and other important documents.<\/p>\n

With a bit of extra time and effort to ensure all of your patients are in-network, you can continue to keep your practice moving forward.\"\"<\/p>\n","protected":false},"excerpt":{"rendered":"

It\u2019s not something that happens often, but despite intake process and office procedures, sometimes you may discover a patient is out-of-network after you’ve completed the appointment. Healthcare is complicated and patients don\u2019t always understand their coverage. A 2013 study published in the Journal of Health Economics found only 14 percent of consumers with private health […]<\/p>\n","protected":false},"author":2,"featured_media":17498,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[110],"tags":[90,38,72],"class_list":["post-17117","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-business-insights","tag-insurance","tag-insurance-checker","tag-quickread"],"acf":[],"yoast_head":"\nWhat to Do When You've Seen a Patient Who Isn\u2019t In-Network<\/title>\n<meta name=\"description\" content=\"It's a scenario you never want to find yourself in but somehow it happens. Here's what to do if you've seen a patient who isn't in-network.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What to Do When You've Seen a Patient Who Isn\u2019t In-Network\" \/>\n<meta property=\"og:description\" content=\"It's a scenario you never want to find yourself in but somehow it happens. Here's what to do if you've seen a patient who isn't in-network.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/\" \/>\n<meta property=\"og:site_name\" content=\"Practice Resources\" \/>\n<meta property=\"article:published_time\" content=\"2017-10-31T13:00:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-10-30T18:55:31+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/thescript.wpengine.com\/wp-content\/uploads\/2018\/10\/thumbnail-5d8c802197db584cfbfc5884242e03b4.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"2500\" \/>\n\t<meta property=\"og:image:height\" content=\"2112\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"thescript\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"thescript\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/\",\"url\":\"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/\",\"name\":\"What to Do When You've Seen a Patient Who Isn\u2019t In-Network\",\"isPartOf\":{\"@id\":\"https:\/\/www.zocdoc.com\/resources\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/thescript.wpengine.com\/wp-content\/uploads\/2018\/10\/thumbnail-5d8c802197db584cfbfc5884242e03b4.jpeg\",\"datePublished\":\"2017-10-31T13:00:00+00:00\",\"dateModified\":\"2023-10-30T18:55:31+00:00\",\"author\":{\"@id\":\"https:\/\/www.zocdoc.com\/resources\/#\/schema\/person\/b1a18498f7008ea20e9b7b8fb4e5c3ae\"},\"description\":\"It's a scenario you never want to find yourself in but somehow it happens. Here's what to do if you've seen a patient who isn't in-network.\",\"breadcrumb\":{\"@id\":\"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/#primaryimage\",\"url\":\"https:\/\/thescript.wpengine.com\/wp-content\/uploads\/2018\/10\/thumbnail-5d8c802197db584cfbfc5884242e03b4.jpeg\",\"contentUrl\":\"https:\/\/thescript.wpengine.com\/wp-content\/uploads\/2018\/10\/thumbnail-5d8c802197db584cfbfc5884242e03b4.jpeg\",\"width\":2500,\"height\":2112,\"caption\":\"patient out of network\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.zocdoc.com\/resources\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"What to Do When You’ve Discovered a Patient is Out-of-Network\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.zocdoc.com\/resources\/#website\",\"url\":\"https:\/\/www.zocdoc.com\/resources\/\",\"name\":\"Practice Resources\",\"description\":\"Useful insights, advice and resources for running and growing your practice from Zocdoc.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.zocdoc.com\/resources\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/www.zocdoc.com\/resources\/#\/schema\/person\/b1a18498f7008ea20e9b7b8fb4e5c3ae\",\"name\":\"thescript\",\"sameAs\":[\"http:\/\/thescript.wpengine.com\"],\"url\":\"https:\/\/www.zocdoc.com\/resources\/author\/thescript\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"What to Do When You've Seen a Patient Who Isn\u2019t In-Network","description":"It's a scenario you never want to find yourself in but somehow it happens. Here's what to do if you've seen a patient who isn't in-network.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/","og_locale":"en_US","og_type":"article","og_title":"What to Do When You've Seen a Patient Who Isn\u2019t In-Network","og_description":"It's a scenario you never want to find yourself in but somehow it happens. Here's what to do if you've seen a patient who isn't in-network.","og_url":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/","og_site_name":"Practice Resources","article_published_time":"2017-10-31T13:00:00+00:00","article_modified_time":"2023-10-30T18:55:31+00:00","og_image":[{"width":2500,"height":2112,"url":"https:\/\/thescript.wpengine.com\/wp-content\/uploads\/2018\/10\/thumbnail-5d8c802197db584cfbfc5884242e03b4.jpeg","type":"image\/jpeg"}],"author":"thescript","twitter_card":"summary_large_image","twitter_misc":{"Written by":"thescript","Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/","url":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/","name":"What to Do When You've Seen a Patient Who Isn\u2019t In-Network","isPartOf":{"@id":"https:\/\/www.zocdoc.com\/resources\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/#primaryimage"},"image":{"@id":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/#primaryimage"},"thumbnailUrl":"https:\/\/thescript.wpengine.com\/wp-content\/uploads\/2018\/10\/thumbnail-5d8c802197db584cfbfc5884242e03b4.jpeg","datePublished":"2017-10-31T13:00:00+00:00","dateModified":"2023-10-30T18:55:31+00:00","author":{"@id":"https:\/\/www.zocdoc.com\/resources\/#\/schema\/person\/b1a18498f7008ea20e9b7b8fb4e5c3ae"},"description":"It's a scenario you never want to find yourself in but somehow it happens. Here's what to do if you've seen a patient who isn't in-network.","breadcrumb":{"@id":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/#primaryimage","url":"https:\/\/thescript.wpengine.com\/wp-content\/uploads\/2018\/10\/thumbnail-5d8c802197db584cfbfc5884242e03b4.jpeg","contentUrl":"https:\/\/thescript.wpengine.com\/wp-content\/uploads\/2018\/10\/thumbnail-5d8c802197db584cfbfc5884242e03b4.jpeg","width":2500,"height":2112,"caption":"patient out of network"},{"@type":"BreadcrumbList","@id":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/patient-out-of-network\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.zocdoc.com\/resources\/"},{"@type":"ListItem","position":2,"name":"What to Do When You’ve Discovered a Patient is Out-of-Network"}]},{"@type":"WebSite","@id":"https:\/\/www.zocdoc.com\/resources\/#website","url":"https:\/\/www.zocdoc.com\/resources\/","name":"Practice Resources","description":"Useful insights, advice and resources for running and growing your practice from Zocdoc.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.zocdoc.com\/resources\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/www.zocdoc.com\/resources\/#\/schema\/person\/b1a18498f7008ea20e9b7b8fb4e5c3ae","name":"thescript","sameAs":["http:\/\/thescript.wpengine.com"],"url":"https:\/\/www.zocdoc.com\/resources\/author\/thescript\/"}]}},"_links":{"self":[{"href":"https:\/\/www.zocdoc.com\/resources\/wp-json\/wp\/v2\/posts\/17117","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.zocdoc.com\/resources\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.zocdoc.com\/resources\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.zocdoc.com\/resources\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.zocdoc.com\/resources\/wp-json\/wp\/v2\/comments?post=17117"}],"version-history":[{"count":0,"href":"https:\/\/www.zocdoc.com\/resources\/wp-json\/wp\/v2\/posts\/17117\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.zocdoc.com\/resources\/wp-json\/wp\/v2\/media\/17498"}],"wp:attachment":[{"href":"https:\/\/www.zocdoc.com\/resources\/wp-json\/wp\/v2\/media?parent=17117"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.zocdoc.com\/resources\/wp-json\/wp\/v2\/categories?post=17117"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.zocdoc.com\/resources\/wp-json\/wp\/v2\/tags?post=17117"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}