Agent says "This provider is participating." This type of benefit should be collected.
What is In Network?
This is another term for non-participating.
What is OON? (or Out of Network?)
If the provider is OON, this is the next prompt.
What is the network status of the practice?
A doctor or practice that agrees to accept a discounted rate for covered services.
What is INN or participating?
This is the scenario in which both in and out of network benefits are collected.
What is, the provider and practice are unknown, and the patient has out of network benefits.
The provider is OON, and the practice is INN, but at a different address. What are the appropriate selections on the platform?
What is Out of Network for provider, and In Network for practice.
Bonus Q! What is the TN?
The agent voluntarily provides the network status of the provider prior to being asked. This information cannot be taken since it was provided before being prompted. True or False.
What is False?
The agent indicates that their systems are down, they are unable to provide the network status of the provider or the practice and there is no EBV. This network status would be collected.
What is 'INN and OON'?
The Agent is unable to give the network status of the provider. What do you select from the drop down and what is your next prompt?
What is "Unknown" and What is the network status of the practice?
Provider participation for these payors can be checked on the website.
What are none?