Out-of-Network Physical Therapy Billing in New York City
A Manhattan physical therapy practice can make a deliberate decision to stay out of network, then discover that a repricer has reduced […]
Pain Management Out-of-network Underpayments: Procedures, Ascs and the No Surprises Act
An in-network ASC can still involve out-of-network pain physicians or anesthesia groups. Since January 1, 2022, eligible No Surprises Act claims have […]
Pediatric Therapy Out-of-Network Underpayment Recovery (OT, PT and Speech)
Your pediatric therapy out-of-network money is leaking in a place most owners don't inspect closely enough. A claim can pay, post, and […]
97110 and 97140 Out-of-Network Reimbursement: What Payers Should Pay
There is no single mandated out-of-network rate for 97110 or 97140. On a four-unit visit billed around $540, repricers often push payment […]
Usual and Customary Rates (UCR) Explained for Out-of-Network Providers
If your out-of-network checks are coming in short, UCR is probably the number behind the damage. It's the payer's allowed-amount benchmark, and […]
Naviguard Underpayment: What Out-of-network Providers Can Do When Unitedhealthcare Reprices a Claim
You're looking at a repriced out-of-network claim and wondering whether UnitedHealthcare just underpaid you or whether you need to move fast to […]
Cigna Data Isight Repricing for Physical Therapy Practices: How to Recover Underpaid Visits
A Manhattan PT visit billed at $540 can come back from Cigna at $60 after Data iSight repricing, even when the same […]
Aetna Out-of-Network Underpayment Appeal Guide for Healthcare Providers
Aetna's initial payment isn't always the final payment. For an out-of-network claim, the practice can often improve its position by identifying the […]
5 Signs Your Out-of-Network Claims Are Being Systematically Underpaid in 2026
A practice likely has a systematic out-of-network underpayment problem when the same CPT code paid by the same payer falls 20% or […]
In-house vs Outsourced Out-of-network Underpayment Recovery Which Is Right for Your Practice
Most independent specialty practices with fewer than 200 out-of-network claims per week recover more net revenue by outsourcing, because the fully loaded […]
Sports Medicine Out-of-Network Billing Services in New Jersey
The right sports medicine out-of-network billing services in New Jersey can recover revenue that routine claim submission leaves behind, but the biggest […]