PATIENT INTIMIDATION AND BALANCE BILLING

You have gone to the doctor to receive the medical care you needed. At the time of your appointment you presented your health insurance card, which they said they accepted, and paid the required co-pay. Two weeks later, you receive a bill from the doctor’s office showing payment from your insurance company, and a claim that you now owe the balance of what the the insurance company didn’t pay. If this scenario sounds familiar, then you have experienced the intimidation and illegal act of balance billing.

Balance billing is the practice of some doctors, hospitals, clinics, and medical facilities who bill patients for the balance of what the patient’s health insurance did not pay. This practice is illegal in the State of Connecticut (See Connecticut General Statutes Section 20-7f). It is illegal for ” any health care provider” to request payment from a person who has health insurance, other than a co-payment or deductible, for medical services covered under a managed health insurance plan.

Isn’t this the reason people get health insurance in the first place? People get health insurance to have the insurance company negotiate health care costs on their behalf. Patients should not be intimated or used as pawns in a fight for money. In fact, the law requires that patients be left out of this negotiation, and that medical providers and insurance companies work all disputes out on their own.

Today more than ever, it is critical that patients know their rights.

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