EPISODE 68~ TOP TIP: Beware of Balanced Billing!

If you choose a managed care plan like an HMO or PPO for your healthcare needs, beware of something called “balance billing.” There are a couple different variations. Many managed care plans negotiate discounted prices with their member doctors. Some doctors then turn around and try to bill the patient to make up the difference. They try to bill you for the BALANCE. Balance billing also happens when a managed care health plan goes bankrupt and doesn’t pay at all. In that case, the doctor may try to bill you for the entire amount. Balance billing is actually illegal in many states. If not, it’s usually contractually prohibited. Bottom line: As long as you see a plan doctor for covered services, a co-payment should be your only responsibility.

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