Thursday, June 2, 2016

What does balance billing mean?

Medicare and Balance Billing

What does the term balance billing mean with regard to Medicare bills?  Suppose you get a lot of testing done for outpatient services.  The first place the claim goes is to Medicare for approval.  If Medicare approves the expense, it then goes to your insurance company.  Any balance remaining after Medicare and the insurance company pay is called a "balance bill".  Under Ohio law, this cannot be passed on to the Medicare consumer. 

Whether or not balance billing can do done is controlled by state.  For example, the state of Florida allows balance billing and Ohio does not.  That means that if you get sick in Florida and don't have a medical plan in place that covers balance billing, you could end up with a bill for Florida services.

The plan choice you make can have financial consequences if you have not considered the concept of balance billing in your choice.  For more information, you can contact Alta Vista Benefits at 614-889-0934.

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