So what is medical balance billing?

Balance billing is the practice of a medical provider (hospital, doctor, lab, etc.) accepting payment from a patient's insurance provider and then turning around and collecting more than the deductible, copayment (copay) or coinsurance from the patient.

 

Here's a simplified example: 

 

Joe Patient goes to the hospital with a heart attack. Joe is billed $100,000.00 by the hospital, but Joe's health insurance company pays the hospital $25,000.00 per their agreement with the hospital. The hospital then turns around and tries to collect $75,000.00 from Joe. This is how people can get caught off guard by medical bills and go bankrupt even when they have health insurance.

Are there any protections for the patient?

Yes, absolutely. In 2013, the Mississippi Legislature enacted a law that protects people from balance billing. 

 

The law states that if a medical provider accepts payment from a health insurance company on behalf of a patient, the medical provider is then prohibited from collecting any amount from the patient above the patient's deductible, co-pay, or co-insurance. Period. End of story.

 

So in the example above, Joe only owes his deductible/copay. Joe does not owe that $75,000.00 the hospital is working to collect. But no one is telling Joe that.

If this is against the law, why is it still happening?

We don't know. Perhaps some medical providers don't know it is illegal, but that seems unlikely. What we do know is that most Mississippians don't know about this protection. We also know that Mississippians are suffering from these illegal medical debt collections every single day.

What does this mean for me?

If you suspect you have been a victim of balance billing, we can help you find out. If you have been a victim, we may be able to stop the collections calls and perhaps even get some or all of your money back. Even if you didn't pay the balance bill, we can still help. Click the button below and we'll review it to see if we might be able to help. There's no cost to you for us to review your case.

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