Ama Policy

Payment for Services Not Authorized by Health Plans H-385.958

Fee Schedules
Our AMA advocates that all health plan contracts contain a provision to permit the direct billing of patients for medical services for which authorization was denied by a health plan, which the rendering physician, based upon reasonable evidence, determines to be essential for the welfare of the patient and for which prior patient consent was obtained.

Policy Timeline 

Sub. Res. 705, I-93Reaffirmation A-02Reaffirmed: CMS Rep. 4, A-12; Reaffirmed: CMS Rep. 1, A-22