Handling Out-of-Network Claims and Maximizing Payments: The BellMedex Advantage

Handling Out-of-Network Claims and Maximizing Payments: The BellMedex Advantage

As healthcare costs continue to rise, many patients are opting for out-of-network (OON) providers to receive the care they need. However, this presents a challenge for both patients and providers as insurance companies often do not cover the full cost of OON services. This is where BellMedex comes in, offering expertise in handling OON claims and helping providers get paid more for their services. In this blog, we will explore the advantages of using BellMedex for OON claims and how their experience can benefit providers.

What are Out-of-Network Claims?

Out-of-network claims are medical bills submitted by providers who do not have a contract with a patient’s insurance company. This often occurs when a patient seeks treatment from a specialist or facility that is not covered by their insurance network. In such cases, patients may be required to pay a higher share of the cost, as insurance companies typically cover a smaller percentage of OON services.

Why is Handling OON Claims Challenging?

Submitting and processing OON claims can be complex and time-consuming. Providers must navigate a range of issues, including negotiating rates with insurance companies, understanding how to bill for OON services, and appealing denied claims. This is especially challenging for small practices that may not have the resources to manage OON claims effectively.

How Can BellMedex Help?

BellMedex is a healthcare revenue cycle management company that specializes in maximizing payments for OON claims. With over 20 years of experience, BellMedex has developed a deep understanding of the complexities of OON billing and reimbursement. They work with providers to navigate the OON landscape and ensure that they receive fair compensation for their services.

Maximizing Payments on OON Claims

BellMedex’s expertise allows them to maximize payments on OON claims in several ways. First, they work with providers to negotiate higher rates with insurance companies. This ensures that providers are compensated fairly for their services, even when treating patients outside of their network. Second, BellMedex uses advanced technology to identify errors and discrepancies in billing, which can lead to denied or underpaid claims. They also provide comprehensive support for the appeals process, helping providers fight back against denied claims.

Experience Matters

BellMedex’s experience in handling OON claims is what sets them apart from other healthcare revenue cycle management companies. Their team of experts understands the nuances of OON billing and reimbursement, and they have a proven track record of success. They also stay up-to-date with the latest changes in healthcare regulations and insurance policies, ensuring that their clients are always well-informed.

One of the biggest challenges in OON scenarios is when the insurance company sends payment directly to the patient instead of the provider. Recovering this money and making systemic changes to change this outcome are paramount to increasing a practice’s revenue.


Navigating the complexities of OON claims can be challenging for healthcare providers, but with the help of BellMedex, it doesn’t have to be. BellMedex’s expertise in maximizing payments on OON claims can help providers get paid more for their services and reduce the burden of managing OON claims. With almost a decade of experience, BellMedex is a trusted partner for healthcare providers looking to streamline their revenue cycle management processes and focus on delivering high-quality care to their patients.

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