Hi Ema Jane!
Great question. Yes some insurers will require you to complete some paperwork in order to bill them as an out of network provider, however many insurers do not! For example, many times with your first claim or two, the medical insurer may ask you to supply a copy of your W-9. As I mentioned, there are some that will ask you fill out and submit some paperwork, and there are some that will refer to an organization such as the CAQH (
https://www.caqh.org/) for credentailing information for their providers, so basically you would just register with CAQH and the insurers that use them would go get your info from them.
In short - we always say don't let out of network paperwork stop you from starting treating your patients and billing their medical! If the insurer requires anything before accepting your claims, you can certainly either call and ask, or file the claim/pre-auth and see if they ask for it then :)
The first step with any patient you see for sleep apnea is going to be to perform a benefit verification call - this will tell you all the good info you need to know like:
- does the patient even have out of network benefits available, or do you need to request a gap?
- how much deductible is left for the year, if any?
- what is the coverage % once the deductible is met?
- is a pre-authorization required before you do it?
Hope this helps!