If you receive a medical bill dunning you for whatever your insurer didn’t pay, take a closer look before writing your check. The New York Times writes that although balance billing is a common practice, it’s not always legal, and you may be able to ignore it.
It is a controversial and sometimes illegal practice: doctors and other health care providers receive a discounted payment from the insurance company–an amount less than the fee they want to be paid–and then they bill the patient for the rest. Most states, including Illinois, have passed laws making balance billing illegal within an insurer’s medical network. And federal law prohibits balance billing by providers paid under Medicare.
But balance billing in these cases can still happen. If you receive a bill from an in-network provider that you are not expecting, call your insurer immediately. “Your insurance company is the best enforcer, if you will, of these laws,” said Jane Cooper, chief executive of Patient Care, a Milwaukee patient advocate firm.
“Avoiding Surprise Bills With Homework and Negotiation” [New York Times]