A nonparticipating physician typically does what?

A nonparticipating physician typically does not accept assignment, meaning they choose not to participate in a particular insurance plan's network. When a physician does not accept assignment, it indicates that they will not agree to accept the insurance company's allowed amount as full payment for services rendered. Instead, the patient may be required to pay the physician's billed rate and subsequently file a claim with the insurance company to seek reimbursement. This can lead to increased out-of-pocket expenses for the patient compared to participating physicians who accept assignment.

In contrast to nonparticipating physicians, those who accept assignment agree to the payment terms set by insurance companies, which can streamline the billing process for patients. Discounted rates and cash payment acceptance are not defining characteristics of nonparticipating physicians and may apply variably based on the individual practice or situation.