Balance Billing

[Boomer]

There is a thread that showed up again today that is about TV Regional Hospital. The topic was started in this forum (Medical and Health) last August.

The thread contains some outstanding information about balance billing. There is a particularly good explanation of the problem that was done by Fran on 8/09.

This may seem like an awkward approach to direct readers to the "balance billing" part of the thread, but I don't know how else to point it out. And the information is extremely important but evolved in the thread so it is not in the subject line.

Make sure you understand what balance billing means. Providers will try to do it sometimes. Maybe it happens because of lack of training for billing staffs. Or maybe it happens because it can be a cash cow, especially where senior citizens are concerned. I am sure the reasons for the practice vary.

And whether you are on Medicare or not, keep an eye on the all too common practice of balance billing. It can happen with any coverage.

I know there are those who are reading this who may be overseeing their parents' medical bills or maybe should be. If you are in that position, it could be especially important that you understand balance billing.

I have a good friend who was seeing this happen to a parent's bills. I explained balance billing to her and she added the two magic words to her communication with the billing staff. The immediate response was impressive. This works especially well if you can work in the words, "I will contact Medicare."

So anyway, the other thread explains this well. If you don't know about it, please have a look.

That's my public service announcement for today.

And I wish I knew how to get the balance billing part of the other thread in here, but I don't.

Boomer

[Frangyomory]

I was a health plan administrator for many years. The issue of balance billing is most important to people on MEDICARE. If a provider accepts Medicare assignment (and you need to ask this of any doctor, lab or hospital you use) they CANNOT bill you for what Medicare does not cover, except deductibles. They will routinely try to do this but you simply respond that as a Medicare provider, they must accept what Medicare pays.

Now if you have Medicare and a supplement, they can send their bill with the Medicare explanation of benefit (EOB) to your secondary insurance. They will then be able to get additional funds from that company. Under NO circumstances except deductible balances, can they bill you after they bill your secondary insurance.

It is MOST importand actually for anyone with insurance coverage to be aware of this.
I would be happy to answer any questions I can if you post them here.

[Boomer]

Fran,

Thank you so much for putting this information in this thread, too. I was hoping that you would. Maybe someone who needs to see this will see it and be helped. This issue can be a real problem and goes on far more often than what we might want to think.

Anyone who has parents who are handling their own medical bills may want to talk with them about watching out for balance billing. I know of one elderly lady who had run her family's business for many years and her mind was still quite sharp, but she ended up caught in a balance billing mess before her daughter found out about it. It all got straightened out, but it should never have happened in the first place.

Boomer