Patient Balance Billing

Good report in Business Week about health providers accepting insurance payment, but then billing patients for additional amounts that should be written off based on the insurance contract.  Most insurance plans pay a steeply discounted rate for hospital and outpatient care.  Although this article isn't very clear on this, some insurance contracts allow doctors to balance bill -and in some states balance billing is legal for Medicare recipients. (In Massachusetts, physicians must agree to Medicare rates if they see Medicare patients).  Remember, most health plans will only pay the lesser of charges or allowable fee schedule - which encourages providers to charge at least a little bit more than the highest amount any health plan will pay!