Cwaples
Guest
When a medical office bills a patient's insurance company for multiple services rendered to the patient and the insurance company only pays a portion or denies some of the fees, does the medical office then have the ability to balance bill by charging the full balance (even up to the usual and customary) for all charges to the patient?
For example, Joe has 2 usual services billed to insurance. Service A is billed at $250 and Service B is billed at $100. Insurance pays the medical office $150 for Service A and $0 for Service B due to a contractual agreement. Can the medical office now bill Joe for the difference of $100 for Service A plus the $100 for Service B, making a total balance of $200 billed to Joe.
In addition, does the State (AZ) matter? and whether it is HMO or PPO?
Thank you to all those who respond!
For example, Joe has 2 usual services billed to insurance. Service A is billed at $250 and Service B is billed at $100. Insurance pays the medical office $150 for Service A and $0 for Service B due to a contractual agreement. Can the medical office now bill Joe for the difference of $100 for Service A plus the $100 for Service B, making a total balance of $200 billed to Joe.
In addition, does the State (AZ) matter? and whether it is HMO or PPO?
Thank you to all those who respond!