Let PracticeMate help you get paid what you deserve from out-of-network claims. Our experts handle the complexity so that you focus on care.
Maximize Your Reimbursements — Even When You’re Out of Network
Are you an out-of-network provider struggling with delayed payments, denied claims, underpaid reimbursements, or frustrated patients? You’re not alone — navigating out-of-network billing is one of the most challenging aspects of running a modern healthcare practice.
At PracticeMate, we specialize in out-of-network medical billing services tailored specifically for physicians, therapists, surgeons, and specialty practices. Our experienced team understands the nuances of out-of-network claims — from verifying benefits and negotiating usual, customary, and reasonable (UCR) fees, to managing appeals and educating patients about their responsibilities.
Whether you’ve chosen to remain independent of insurance networks for greater autonomy and higher-quality care, or you’re transitioning to an out-of-network model to regain control of your practice, we’re here to help you:
Recover maximum allowable reimbursements from insurers.
Reduce the administrative burden on your staff.
Avoid costly compliance pitfalls.
Improve patient satisfaction with clear, transparent billing communication.
With PracticeMate, you can confidently deliver care without worrying about collections or leaving money on the table, while keeping your practice compliant, profitable, and stress-free.
✅Proven Results: We’ve recovered millions in out-of-network reimbursements for healthcare providers.
✅Expertise Across Payers: Familiar with UCR (Usual, Customary & Reasonable) charges, patient responsibility, balance billing, and appeal processes.
✅Transparent Process: You’ll always know the status of your claims and payments timeline.
✅Compliant & Ethical: Stay HIPAA-compliant while maximizing revenue legally.
✅Dedicated Account Manager: Always have a point of contact who understands your practice.
As an out-of-network provider, you’re up against higher claim denials, lower patient collections, unpredictable payments, and complex fee negotiations — all while trying to provide excellent care. Our team of out-of-network billing experts knows exactly how to navigate these challenges. We fight for your rightful payments, ensuring insurance carriers honor their obligations and reimburse you fairly.
Our experienced out-of-network billing specialists use proven negotiation strategies and appeals expertise to maximize your reimbursements, often increasing collections by 30–50% more than providers handling billing themselves or using generic billing services.
With PracticeMate, you don’t need to worry about learning new systems or disrupting your operations. Our out-of-network billing experts work seamlessly within your existing EHR, practice management (PM) systems, and clearinghouse — delivering accurate, timely billing without any retraining or downtime.
We provide complete out-of-network medical billing services designed to help healthcare providers recover maximum allowable reimbursements, reduce denials, improve patient experience, and streamline workflows — all while staying compliant and stress-free.
Here’s how our team of out-of-network billing experts supports you:
Before the visit, our team performs thorough patient eligibility verification to confirm out-of-network benefits, deductibles, co-insurance, and coverage limits. This upfront benefits coordination improves patient understanding of their financial responsibility and helps avoid claim rejections or surprises later.
Our out-of-network billing specialists ensure every service is documented accurately and coded correctly with ICD-10, CPT, and HCPCS codes, aligned with UCR (Usual, Customary, and Reasonable) rates. We file clean claims promptly to reduce delays, denials, and penalties, keeping your revenue cycle healthy.
Insurance carriers often offer low rates for out-of-network claims, but our team proactively negotiates out-of-network fees based on UCR benchmarks and market data. By advocating for your fair payment and pushing back on insufficient offers, we help you secure higher reimbursement rates.
Because out-of-network claims often face heightened scrutiny, we closely monitor each claim for denials or underpayments. When a claim is denied, our out-of-network billing experts file aggressive appeals with supporting documentation, citing payer policies and regulations to ensure claims are paid correctly.
We know that out-of-network billing can lead to confusion for patients. That’s why we deliver clear, accurate patient statements that explain costs, insurance payments, and outstanding balances. Our patient-friendly collections support helps recover balances while preserving trust and satisfaction.
Our detailed analytics dashboards allow you to track key performance indicators (KPIs) such as collections, denial trends, UCR rates, and patient payments. These insights reveal opportunities to optimize your out-of-network billing process and prevent revenue leakage.
✅Onboarding & Benefit Analysis: We assess your out-of-network benefits profiles.
✅Eligibility & Verification: Confirm coverage details before treatment using tech and tools.
✅Claim Creation & Submission: Ensure accurate coding and maximum UCR rates.
✅Negotiation & Follow-up: Proactive payer communication and appeals when necessary.
✅Patient Balance Resolution: Provide statements and answer patient billing questions.
✅Transparent Reporting: Monitor performance and payment trends anytime using KPIs.
We proudly serve out-of-network providers across the United States, including:
We help out-of-network providers in many specialties, such as:
We work with the tools you already use. PracticeMate integrates effortlessly with leading electronic health record (EHR) and practice management systems (PMS) such as:
Stop leaving money on the table. Let PracticeMate’s out-of-network billing experts handle the hassle while you focus on your patients.
FaqsOut-of-network billing refers to submitting claims to insurance carriers when you are not contracted (in-network) with them. The payer reimburses at UCR rates, and the patient may be responsible for a larger portion.
Yes. Out-of-network providers can still receive payment from insurers, though at non-contracted rates. We help ensure you’re reimbursed at the maximum allowable rates.
Insurers scrutinize out-of-network claims more often, frequently underpaying or denying them. Knowing how to negotiate, appeal, and document properly is key, which is why hiring a specialized billing partner helps.
Every case is different, but our clients often see 20–50% higher collections compared to managing out-of-network billing on their own.
Yes — we help educate patients about their responsibilities and assist with statements and payment plans if needed.
