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 is the practice of billing a Member the difference between the reimbursed amount for a covered service and a higher amount the Provider wants as payment.
Balance billing L.A. Care Members is prohibited by law in most circumstances.
Balance billing by Provider, as defined in regulations of the Idaho Department of Insurance, is prohibited by the Agreement.
More Definitions of Balance billing
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 an air ambulance provider billing for the
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 the requirement, with respect to the providers shown below, that any amount above the Allowable Expenses shall not be payable by a Covered Person.
Balance billing means the practice of charging