Maddux tuition??

[Anonymous]

what is OON at 50 Pct?

[Anonymous]

I think it means out of network they pay 50% of the cost for the service (e.g. speech therapy) or OT.

[Anonymous]

Anonymous wrote:what is OON at 50 Pct?

not pp, but it probably means that the reimbursement is at the Out Of Network rate of 50 percent of whatever the "usual customary and reasonable rate". The UCR is determined by your insurance company and is the
same for all providers of a certain procedure. If it is OON, you will be responsible for any difference between bill and reimbursement (called "balance billing.") In network providers agree to eat this difference.

For example, I go to my OON Gyn for an annual exam. She bills $300. Insurance company says UCR IS $200 and reimburses me 50% or $100. I am out the difference between $300 and $100.

You can get the UCR for a particular procedure or therapy from your insurer in advance. Might need to ask provider or school for billing code.