A Note From The Author

Many out-of-network ("OON") practices and facilities make the mistake of not understanding the requirements in their jurisdiction regarding balance billing their patients. A balance bill is the difference between charges and all payments received. OON providers make the mistake of billing OON patients the difference between allowed amounts and payments received or discounting the cost share based upon in-network or Medicare cost-shares.

Insurers are very active in auditing such OON practices and facilities that make these mistakes and litigation brought by insurers against OON practices and facilities is on the rise all over the United States.

Thomas J. Force, Esq., President, The Patriot Group and The Force Law Firm, PC.