Which statement about the usual and customary rate (UCR) in health insurer reimbursement is NOT correct?

The statement regarding changes involving the usual and customary rate (UCR) having no effect on balance billing is not accurate. In practice, modifications to how UCR is determined and reimbursed can have a significant impact on balance billing. When insurers adjust their UCR calculations, it may lead to lower reimbursements for services, which in turn can increase the likelihood that patients will experience balance billing. This occurs when providers bill patients for the difference between what the insurer pays and what they charge for their services.

In contrast, when there are improvements or adjustments to the UCR system, it often aims to align payments more closely with the average costs of services in a given geographic area. Such changes can help reduce the discrepancies between what patients owe and what insurers pay. Therefore, variations in UCR impact balance billing practices and patient financial responsibility.

The other statements hold validity within the context of UCR, such as the involvement of independent entities in managing UCR databases, shifts in insurer practices regarding traditional UCR formulas, and the correlation between UCR adjustments and reduced balance billing instances.