Awareness : OBC Tips

Research Billing:“Reasonable and Necessary”

Do not bill insurance for anything that is not “reasonable and necessary.”

  • Experimental and investigational items/services are not generally “reasonable and necessary.”
  • Items/services solely for data collection or screening are not generally “reasonable and necessary.”
  • Items/services billed to insurance that are related to a study should be those items that are routinely provided to patients not in a study.