That depends. Have you ever wondered why just about every practitioner who dispenses orthotics will recommend it to you, even when you haven’t requested it?
Most insurance companies pay claims based on the reasonable & customary (“R&C”) amount of that service. This means that fair market pricing is employed. This means that your plan members will be reimbursed only the R&C amount of the claim they submit. For example, if a plan member decides to go to Elmwood Spa in downtown […]
Our paramedical claims manager had a very enlightening discussion with a chiropractor about a insurance fraud scams around compression hose. Compression Hose Fraud is Widespread in Benefit Plans Drug stores are “working out a deal” with some customers who have insurance coverage regarding the compression hose. The member is informed to get a prescription from […]