If you have some unique advantage as a practitioner compared to your peers and are in high demand, it might make sense to go out of network with poor-paying carriers.
In some cases, you may be forced to go out-of-network by carriers who thin down their provider roster or force unreasonable fee schedules.
Making a decision to go out of network involves several factors:
All factors have to be considered carefully before electing to go out of network. Sometimes it may be prudent to negotiate with the carrier before making a decision.
Finally, patient perception is very important. You have to make sure that your out-of-network fee schedule is reasonable and can withstand scrutiny. Patients also have to be provided a clear estimate of their out-of-pocket costs prior to services.
All things considered, going out of network (either by choice or by force) can have significant financial implications - positive or negative and has to be carefully managed.