How Do Mental Health Parity Laws Impact "Usual, Customary and Reasonable"
Usual, Customary and Reasonable Benefit Adjustments are often ambiguously applied to out-of-network claims and providers are left with little understanding of if the benefit calculation is accurate or not.
While these balances are often the patient's responsibility, many healthcare providers take on the advocacy role by seeking clarification regarding the UCR calculation, appealing excessively large discounts and seeking input on what pricing database was used to calculate the benefit.. . . . (to read the remainder of this article, please log in below.) The resource you have requested is available only to current members.
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