Clinic "out of network" for insurance

JosephinesMommy

New member
Just got a $300.00 bill for my daughters clinic visit. Even though there is only one clinic in the state (Oregon) we have to pay for out of network. Any one else dealt with insurance and this issue?
 

JosephinesMommy

New member
Just got a $300.00 bill for my daughters clinic visit. Even though there is only one clinic in the state (Oregon) we have to pay for out of network. Any one else dealt with insurance and this issue?
 

JosephinesMommy

New member
Just got a $300.00 bill for my daughters clinic visit. Even though there is only one clinic in the state (Oregon) we have to pay for out of network. Any one else dealt with insurance and this issue?
 

JosephinesMommy

New member
Just got a $300.00 bill for my daughters clinic visit. Even though there is only one clinic in the state (Oregon) we have to pay for out of network. Any one else dealt with insurance and this issue?
 

JosephinesMommy

New member
Just got a $300.00 bill for my daughters clinic visit. Even though there is only one clinic in the state (Oregon) we have to pay for out of network. Any one else dealt with insurance and this issue?
 

Ratatosk

Administrator
Staff member
Clinic "out of network

You have to get a referral from your clinic. We had this issue when DS had to be lifeflighted to a hospital in the City shortly after he was born for emergency surgery. It took several months 'cuz I got the run around, but DS' primary doctor at the in-network clinic got the ball rolling so the people who were able to refer -- believe it was the head of the hospital, submitted the paperwork.
 

Ratatosk

Administrator
Staff member
Clinic "out of network

You have to get a referral from your clinic. We had this issue when DS had to be lifeflighted to a hospital in the City shortly after he was born for emergency surgery. It took several months 'cuz I got the run around, but DS' primary doctor at the in-network clinic got the ball rolling so the people who were able to refer -- believe it was the head of the hospital, submitted the paperwork.
 

Ratatosk

Administrator
Staff member
Clinic "out of network

You have to get a referral from your clinic. We had this issue when DS had to be lifeflighted to a hospital in the City shortly after he was born for emergency surgery. It took several months 'cuz I got the run around, but DS' primary doctor at the in-network clinic got the ball rolling so the people who were able to refer -- believe it was the head of the hospital, submitted the paperwork.
 

Ratatosk

Administrator
Staff member
Clinic "out of network

You have to get a referral from your clinic. We had this issue when DS had to be lifeflighted to a hospital in the City shortly after he was born for emergency surgery. It took several months 'cuz I got the run around, but DS' primary doctor at the in-network clinic got the ball rolling so the people who were able to refer -- believe it was the head of the hospital, submitted the paperwork.
 

Ratatosk

Administrator
Staff member
Clinic "out of network

You have to get a referral from your clinic. We had this issue when DS had to be lifeflighted to a hospital in the City shortly after he was born for emergency surgery. It took several months 'cuz I got the run around, but DS' primary doctor at the in-network clinic got the ball rolling so the people who were able to refer -- believe it was the head of the hospital, submitted the paperwork.
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V

valigirl21

Guest
Clinic "out of network

I know you probably don't want to here this, but maybe a clinic in NoCal or Wash. is in network. It seems the path of least resistance anyway. A few questions:

1.Did the clinic receive payment from you insurance company?
2.Were they paid an equal or greater amount than they would have if they were in network?

I ask because if they have been reimbursed at an equal or greater rate you may have some bargaining room as far as your part of the bill. Will your clinic be willing to accept your costshare at an in-network rate? Talk to a social worker or the billing department at your daughter's clinic. They may be able to work with you or point you in the right direction.
 
V

valigirl21

Guest
Clinic "out of network

I know you probably don't want to here this, but maybe a clinic in NoCal or Wash. is in network. It seems the path of least resistance anyway. A few questions:

1.Did the clinic receive payment from you insurance company?
2.Were they paid an equal or greater amount than they would have if they were in network?

I ask because if they have been reimbursed at an equal or greater rate you may have some bargaining room as far as your part of the bill. Will your clinic be willing to accept your costshare at an in-network rate? Talk to a social worker or the billing department at your daughter's clinic. They may be able to work with you or point you in the right direction.
 
V

valigirl21

Guest
Clinic "out of network

I know you probably don't want to here this, but maybe a clinic in NoCal or Wash. is in network. It seems the path of least resistance anyway. A few questions:

1.Did the clinic receive payment from you insurance company?
2.Were they paid an equal or greater amount than they would have if they were in network?

I ask because if they have been reimbursed at an equal or greater rate you may have some bargaining room as far as your part of the bill. Will your clinic be willing to accept your costshare at an in-network rate? Talk to a social worker or the billing department at your daughter's clinic. They may be able to work with you or point you in the right direction.
 
V

valigirl21

Guest
Clinic "out of network

I know you probably don't want to here this, but maybe a clinic in NoCal or Wash. is in network. It seems the path of least resistance anyway. A few questions:

1.Did the clinic receive payment from you insurance company?
2.Were they paid an equal or greater amount than they would have if they were in network?

I ask because if they have been reimbursed at an equal or greater rate you may have some bargaining room as far as your part of the bill. Will your clinic be willing to accept your costshare at an in-network rate? Talk to a social worker or the billing department at your daughter's clinic. They may be able to work with you or point you in the right direction.
 
V

valigirl21

Guest
Clinic "out of network

I know you probably don't want to here this, but maybe a clinic in NoCal or Wash. is in network. It seems the path of least resistance anyway. A few questions:
<br />
<br /> 1.Did the clinic receive payment from you insurance company?
<br /> 2.Were they paid an equal or greater amount than they would have if they were in network?
<br />
<br />I ask because if they have been reimbursed at an equal or greater rate you may have some bargaining room as far as your part of the bill. Will your clinic be willing to accept your costshare at an in-network rate? Talk to a social worker or the billing department at your daughter's clinic. They may be able to work with you or point you in the right direction.
 

Buckeye

New member
Clinic "out of network

Somebody correct me if I'm wrong but I thought if they did not have a CF clinic in network then they would have to cover the out of network one at the in network rates. I know when we had the genetic testing done they refused to cover in network until we asked where we could send it in network and they had no answer - they ended up covering it as if in network. Maybe a letter from your CF clinic explaining why your child needs to go to a CF clinic vs a in network pediatrician or pulmonogist would help.
 

Buckeye

New member
Clinic "out of network

Somebody correct me if I'm wrong but I thought if they did not have a CF clinic in network then they would have to cover the out of network one at the in network rates. I know when we had the genetic testing done they refused to cover in network until we asked where we could send it in network and they had no answer - they ended up covering it as if in network. Maybe a letter from your CF clinic explaining why your child needs to go to a CF clinic vs a in network pediatrician or pulmonogist would help.
 

Buckeye

New member
Clinic "out of network

Somebody correct me if I'm wrong but I thought if they did not have a CF clinic in network then they would have to cover the out of network one at the in network rates. I know when we had the genetic testing done they refused to cover in network until we asked where we could send it in network and they had no answer - they ended up covering it as if in network. Maybe a letter from your CF clinic explaining why your child needs to go to a CF clinic vs a in network pediatrician or pulmonogist would help.
 

Buckeye

New member
Clinic "out of network

Somebody correct me if I'm wrong but I thought if they did not have a CF clinic in network then they would have to cover the out of network one at the in network rates. I know when we had the genetic testing done they refused to cover in network until we asked where we could send it in network and they had no answer - they ended up covering it as if in network. Maybe a letter from your CF clinic explaining why your child needs to go to a CF clinic vs a in network pediatrician or pulmonogist would help.
 

Buckeye

New member
Clinic "out of network

Somebody correct me if I'm wrong but I thought if they did not have a CF clinic in network then they would have to cover the out of network one at the in network rates. I know when we had the genetic testing done they refused to cover in network until we asked where we could send it in network and they had no answer - they ended up covering it as if in network. Maybe a letter from your CF clinic explaining why your child needs to go to a CF clinic vs a in network pediatrician or pulmonogist would help.
 
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