The Hidden Revenue Risks of Out-of-Network Claims
Handling out-of-network (OON) claims is one of the most complex parts of Revenue Cycle Management (RCM) for healthcare providers. When a patient receives care from a provider who is not part of their insurance network, it creates several financial challenges for both the practice and the patient. These claims often lead to lower reimbursement rates, complicated billing procedures, delayed payments, and a higher chance of denials.