Thursday, May 24, 2018

What is balance billing?

Balance billing is another term for Part B excess charges.  What does that mean?
If you have outpatient surgery, testing and other Part B services and you have a Medicare Supplement, the provider is not allowed to bill you for what your supplement coverage does not cover. 

For example, let's say you have a Plan G Medicare Supplement.  A bill comes to you for $500.00 from a provider.  Plan G has an annual Part B deductible of $183.  So, you are only responsible for $183 each calendar year for Medicare approved expenses.  The provider is not allowed to bill for any more than that.

It is import to look at two pieces of documentation:  the Medicare Explanation of Benefits and the insurance company explanation of benefits.  Medicare indicates what you MAY owe and the insurance company indicates what you do owe.  You should not pay any bills until you look at the insurance company's documentation.  A provider can bill you but you may not really owe them.

For more information, you can contact us at 614-889-0934.

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