Patient Balance Billing Lawsuits

Billing out-of-network can be extremely complex, especially with respect to patient balance billing.  Due to being the leading medical billing company when it comes to out-of-network billing, Apache Health often gets questions from our clients and prospective clients on whether they can balance bill patients in full or waive patient balances.

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Any Willing Provider Statutes

The Provider-Payer Battle

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California Medical Billing - Balance Billing

Apache Health receives frequent inquiries about California medical billing and whether it is legal to balance bill in full or contrarily to waive patient balances.  As noted in greater detail in some prior articles we have written, facility-based physician groups like for anesthesia billing, radiology billing, hospitalist billing, and ER billing often seek to balance bill a patient in full when they are out of network, however facilities like ASC billing, laboratory billing, and imaging center billing often seek to waive the patient balances in whole or in part when billing out of network.  Following is some information specific to California rules and regulations regarding patient balance billing.

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Waiving Patient Balances – Part 2

We frequently get medical billing questions from out of network providers (non-contracted) especially for referral-based facilities like imaging center billing, laboratory billing, and ASC  billing is whether they can waive patient balances.  Following is the second part to the article about the rules and regulations surrounding waiving patient balances that may help your practice.

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Waiving Patient Balances – Part 1

One of the most common medical billing questions we get from out of network providers (non-contracted) especially for referral-based facilities like imaging center billing, laboratory billing, and ASC billing is whether they can waive patient balances.  Following is some information that may help your practice.

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Medical Billing - Treating Patients As If "In Network"

The last medical billing article in this series discussed the potential benefits of medical billing out of network with a high fee schedule.  We concluded that billing a higher fee schedule out of network generated more revenue per encounter for physicians and other providers with the limiting factor being high patient balances and balance billing.  In this article we will discuss one of the ways in which a provider can lessen the impact on patients of billing a high fee schedule OoN.

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Patient Balance Billing

Myth and misinformation is rampant in this industry.  Ask a dozen different medical billing companies whether or not it is legal to balance bill patients and you will get a dozen different answers, most of which will be wrong and all of which will be supported by the fact that they present themselves as “medical billing experts”.

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