Several major insurers are contracting with repricing companies to provide repricing services for out-of-network claims, often undervaluing physical therapist services.
This practice leads to significant underpayments to providers and unexpected out-of-pocket costs for patients.
Now available: an APTA Practice Advisory on commercial insurance out-of-network repricing. This resource provides details on what providers should know about these repricing practices, including how to manage out-of-network billing when a repricing entity is involved, what to do if you’ve already accepted a discounted rate, and the actions to take to raise the issue with patients and relevant state insurance authorities.
The APTA Practice Advisory, a member benefit, provides background information on this issue, as well as practical steps providers can take to ensure that they are not underpaid for physical therapist services.
For questions related to this advisory, contact APTA Advocacy.