TOut-of-network providers who have been approved to render services to Healthfirst members will be reimbursed at the Healthfirst Standard Out-of-Network Fee Schedule applicable to the member’s Healthfirst plan
These fee schedules are established as a percentage of Medicaid or Medicare (depending upon the service and the member’s Healthfirst plan). These out-of-network fee schedules apply to the following plans
In these instances, the Explanation of Payment will indicate “OON RATE: SEE HEALTHFIRST.ORG”.
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