• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to footer
  • About Us
  • Medical Billing Process
  • Insurance Contacts & Addresses
    • with Alphabet A to E
      • Insurance Companies with Alphabet A
      • Insurance Companies with Alphabet B
      • Insurance Companies with Alphabet C
      • Insurance Companies with Alphabet D
      • Insurance Companies with Alphabet E
    • With Alphabet F to J
      • Insurance Companies with Alphabet F
      • Insurance Companies with Alphabet G
      • Insurance Companies with Alphabet H
      • Insurance Companies with Alphabet I
      • Insurance Companies with Alphabet J
    • With Alphabet K to O
      • Insurance Companies with Alphabet K
      • Insurance Companies with Alphabet L
      • Insurance Companies with Alphabet M
      • Insurance Companies with Alphabet N
      • Insurance Companies with Alphabet O
    • With Alphabet P to T
      • Insurance Companies with Alphabet P
      • Insurance Companies with Alphabet Q and R
      • Insurance Companies with Alphabet S
      • Insurance Companies with Alphabet T
    • With Alphabet U to Z
      • Insurance Companies with Alphabet U
      • Insurance Companies with Alphabet V
      • Insurance Companies with Alphabet W to Z
  • BCBS Prefix
    • BCBS Alpha Prefix
      • Prefix with Alphabet A to E
        • Prefix List (AAA to AZZ)
        • Prefix List (BAA to BZZ)
        • Prefix List (CAA To CZZ)
        • Prefix List (DAA To DZZ)
        • Prefix List (EAA to EZZ)
      • Prefix with Alphabet F to J
        • Prefix List (FAA to FZZ)
        • Prefix List (GAA to GZZ)
        • Prefix List (HAA to HZZ)
        • Prefix List (IAA to IZZ)
        • Prefix List (JAA to JZZ)
      • Prefix with Alphabet K to O
        • Prefix List (KAA to KZZ)
        • Prefix List (LAA to LZZ)
        • Prefix List (MAA to MZZ)
        • Prefix List (NAA to NZZ)
        • Prefix List (OAA to OZZ)
      • Prefix with Alphabet P to T
        • Prefix List (PAA to PZZ)
        • Prefix List (QAA to QZZ)
        • Prefix List (RAA to RZZ)
        • Prefix List (SAA to SZZ)
        • Prefix List (TAA to TZZ)
      • Prefix with Alphabet U to Z
        • Prefix List (UAA to UZZ)
        • Prefix List (VAA to VZZ)
        • Prefix List (WAA to WZZ)
        • Prefix List (XAA to XZZ)
        • Prefix List (YAA to YZZ)
        • Prefix List (ZAA to ZZZ)
    • BCBS Alpha Numeric Prefix
      • Prefix with Alphabet A to E
        • Prefix List (A2A To A9Z)
        • Prefix List (B2A To B9Z)
        • Prefix List (C2A To C9Z)
        • Prefix List (D2A To D9Z)
        • Prefix List (E2A to E9Z)
      • Prefix with Alphabet F to J
        • Prefix List (F2A to F9Z)
        • Prefix List (G2A to G9Z)
        • Prefix List (H2A to H9Z)
        • Prefix List (I2A to I9Z)
        • Prefix List (J2A To J9Z)
      • Prefix with Alphabet K to O
        • Prefix List (K2A To K9Z)
        • Prefix List (L2A To L9Z)
        • Prefix List (M2A To M9Z)
        • Prefix List (N2A To N9Z)
        • Prefix List (O2A To O9Z)
      • Prefix with Alphabet P to T
        • Prefix List (P2A To P9Z)
        • Prefix List (Q2A To Q9Z)
        • Prefix List (R2A To R9Z)
        • Prefix List (S2A To S9Z)
        • Prefix List (T2A To T9Z)
      • Prefix with Alphabet U to Z
        • Prefix List (U2A To U9Z)
        • Prefix List (V2A To V9Z)
        • Prefix List (W2A To W9Z)
        • Prefix List (X2A To X9Z)
        • Prefix List (Y2A To Y9Z)
        • Prefix List (Z2A To Z9Z)
  • CPT Codes
  • Modifiers
Billing Executive

Billing Executive

Medical Billing Knowledge Base

  • Medical Billing
  • Medical Coding
  • CMS
  • Private Payers
  • Billing Errors
  • Resources
  • Buy Books & Courses

How to check UCR rate for an out-of-network claim by state and region

February 28, 2023 by Aamir247 Leave a Comment

An out-of-network provider is a healthcare provider or facility that does not have a contract with your insurance company. If you receive care from an out-of-network provider, you may be responsible for a greater share of the cost. The customary rate for an Out of network claim is the rate or amount that is typically charged by providers for a specific service or procedure in a specific region or state.

Out-of-network usual, customary, and reasonable (UCR) rate is the amount that healthcare providers typically charge for a specific service or procedure in a certain geographic area. It is used by insurance companies to determine how much they will reimburse for out-of-network claims.

Here are some websites that allow you to check the UCR rate for an out-of-network claim by state and region:

  • Fair Health Consumer Website: Allows you to search for the UCR rate for a specific procedure or service in your area.
  • Healthcare Bluebook: Provides UCR rate information as well as a “fair price” for procedures and services.
  • Healthcare Cost Estimator by UnitedHealthcare: Allows you to search for the UCR rate for a specific procedure or service in your area.
  • Medicare.gov: Provides UCR rate information for specific procedures and services.
  • HealthSparq: Allows you to search for the UCR rate for a specific procedure or service in your area based on your insurance plan.
  • Healthcare.com: Allows you to search for the UCR rate for a specific procedure or service in your area.

Please keep in mind that these websites are not exhaustive and may not have information for all providers and regions. Additionally, your state’s Medicaid website or private health insurance company’s website may also provide the UCR rate information for out-of-network claims in your area. It is important to note that these websites are informative and not authoritative and best way is to check with your insurance company.

It’s important to note that these websites may not provide the exact customary rate for a specific provider and it’s always good to check with your insurance company or the provider for the most accurate information.

…………..

Billing Executive offers expert advice on how to choose an EHR, Medical Billing Software and Medical Billing and Credentialing Companies.

Make sure to like, share, and subscribe Billing Executive or visit our website for regular learning about Medical Billing.

Learn more about Medical Billing and Coding Tips, here.

Post Views: 17

Filed Under: Medical Billing, Payer Portals, Posts, Resources

Reader Interactions

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Primary Sidebar

Medical Billing & Coding Books

1 Stop Medical Billing Solutions

Save Time & Money by choosing “ONE STOP“ Solutions!

Revenue Cycle Management
Online Reputation
Virtual Staffing (RPO)

Free Standing Emergency Rooms, Micro Hospitals

www.rcmxpertz.com

Books for HCPCS & CPT Codes 2023

E-mail Newsletter

  • Facebook
  • GitHub
  • Instagram
  • Pinterest
  • Twitter
  • YouTube

Medical Jobs & Projects

  • Integrated Medical Services (IMS)

    Certified Medical Coder

    • Phoenix, AZ
    • Integrated Medical Services (IMS)
    • Full Time
  • Yeo & Yeo

    Medical Biller

    • Saginaw, Michigan
    • Yeo & Yeo
    • Full Time
  • UnitedHealth Group

    (OP) Medical Coder

    • HARTFORD, CONNECTICUT
    • UnitedHealth Group
    • Full Time
  • Aston Carter

    Medical Biller

    • Atlanta - Fulton County - GA Georgia - USA
    • Aston Carter
    • Full Time
  • Yeo & Yeo Affiliated Medical Billing

    Medical Biller

    • Saginaw, Michigan
    • Yeo & Yeo Affiliated Medical Billing
    • Full Time

Footer

Billing Executive – a “Medical Billing and Coding Knowledge Base” for Physicians, Office staff, Medical Billers and Coders, including resources pertaining to HCPCS Codes, CPT Codes, ICD-10 billing codes, Modifiers, POS Codes, Revenue Codes, Billing Errors, Denials and Rejections. Learn more about us!

Quick Links

  • Expert Advice for Medical Billing & Coding
  • Medical Billing and Coding Courses
  • List a Medical Billing Job or a Project
  • Medical Billing and Coding Jobs
  • Contact Us

Subscribe via Email

  • Privacy Policy

Proudly created by AJ Graphics

DISCLAIMER: Billing Executive does not claim ownership of all the informational content published or shared on this website, including any content shared by third parties. The content published or shared on this website, including any content shared by third parties is for informational/educational purposes.