Balance billing means charging or collecting an amount in excess of the Medicaid, Medicare, or contracted reimbursement rate for services covered under a Medicaid, Medicare or employer sponsored beneficiary’s plan. “Balance Billing” does not include charging or collecting deductibles or copayments and coinsurance required by the beneficiary’s plan.
Balance billing means charging a person, on whose behalf a workers' compensation insurance carrier or self-insured employer is obligated to pay medical benefits under this chapter or Chapter 3, Utah Occupational Disease Act, for the difference between what the workers' compensation insurance carrier or self-insured employer reimburses the hospital for covered medical services and what the hospital charges for those covered medical services.
Balance billing means the practice of a provider billing for the difference between the provider's charge and the health carrier's allowed amount;
Examples of Balance billing in a sentence
Balance billing occurs when a provider receives less than the total amount billed from a patient’s HMO and subsequently bills the unpaid balance directly to the patient.
Balance billing occurs when physicians are paid according to the MCO/IMCS contract or the Arkansas Workers' Compensation Fee Schedule, the amount they were paid is less than the amount of their bill, and they attempt to collect the difference from employees.
More Definitions of Balance billing
Balance billing means the practice of an air ambulance provider billing for the
Balance billing means a health care provider’s demand that a patient pay a greater amount for a given service than the amount the individual’s insurer, managed care organization, or health service corporation has paid or will pay for the service.
Balance billing means the practice of an air ambulance provider billing for the difference between the air ambulance provider's charge and the health care insurer's allowed amount.
Balance billing means the practice of charging an enrollee in a health benefit plan that uses a provider network to recover from the enrollee the balance of a non-network health care provider's fee for service received by the enrollee from the health care provider that is not fully reimbursed by the enrollee's health benefit plan.
Balance billing means charging a covered person who is insured through a health benefit plan that
Balance billing means a non-network provider billing you for the difference between the provider’s charge for a service and the eligible service expense. Network providers may not balance bill you for covered service expenses.
Balance billing means the practice by a provider, who does not participate in an enrollee’s health benefit plan network, of charging the enrollee the difference between the provider’s fee and the sum of what the enrollee’s health benefit plan pays and what the enrollee is required to pay in applicable deductibles, co-payments, coinsurance or other cost-sharing amounts required by the health benefit plan.