balance billing


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balance billing

Managed care The practice of billing Pts in excess of the amount approved for payment by a health plan, Medicare, or private fee-for-service insurance. See Allowable charge, Nonparticipating physician.

bal·ance bill·ing

(bal'ăns bil'ing)
Sending a financial statement to the patient for the remainder of the amount charged and remaining unpaid after the third-party payer has submitted their financial contribution.

bal·ance bil·ling

(bal'ăns bil'ing)
Sending a financial statement to the patient for the remainder of the amount charged and remaining unpaid after the third-party payer has submitted their financial contribution.
References in periodicals archive ?
The balance billing issue returned as a key agenda item for the 2017 Texas Legislature, as it is in many other states as well.
Senate of Texas, Texas Legislature Passes Balance Billing Mediation
108) There has been a movement within the past several years to allow Medicare-contracted physicians to go beyond the limited reimbursement available through the balance billing of unassigned claims.
the UCR and Medicare rate) to determine reimbursement, excessive balance billing for emergency care, lack of disclosure for nonemergency care, and difficulty submitting claims.
The plan must also provide that the hospital give enrollees prior notice before they receive inpatient services and certain other services, when the amount of balance billing could be substantial.
Change the prohibition on balance billing, and you will have solved the problem.
As with balance billing, participating provider rates vary by specialty with psychiatrists, anesthesiologists, and general practice physicians having the lowest participation rates among specialty groups (Physician Payment Review Commission, 1993).
That appears to be the intent of this bill - it's why the bill's supporters torpedoed attempt after attempt to insert consumer protections against balance billing during the legislative process.
In his Sona on Monday, Duterte said that the government expanded PhilHealth coverage and benefits and strengthened the No Balance Billing (NBB) policy, which exempts indigents and other marginalized sectors from paying their bills in government hospitals.
State insurance regulators talked about the air ambulance services balance billing problem this summer in San Diego, at a meeting of the Kansas City, Missouri-based National Association of Insurance Commissioners.
Like Medicare, the Medicaid prohibition against balance billing is comprehensive, though it does not have the restrictive exceptions found in Medicare reimbursement law.
His comments followed a letter he sent to Kitzman expressing his concern over her decision to propose changes to the so-called balance billing rule passed by her predecessor.