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  • Writer's pictureGrady Legal

Balanced Bill & Now you have Medical Debt!

You have an unexpected visit to the hospital, but you are confident your medical bills are covered after you pay your coinsurance, deductibles, and copayments. Right? After all isn’t that what health insurance is for? As you are recovering, surprisingly, bills begin to arrive from the hospital as well as doctors and medical practices that you never knew existed.

Welcome to the world of balance billing and unfair medical debt.

Balance bills are the difference between what the provider (hospital or doctor) charges and what the insurance (carrier or payer) pays. It often comes as the result of a provider being out-of-network or for services not covered by your plan. Even if the facility is in-network.

Unfortunately, these bills are perfectly legal. Some states have enacted feeble legislation in an effort to reduce the surprise of these balance bills. For instance, in Florida, a statute was enacted to limit how much an out of network doctor can bill for procedures done in an in-network facility.

Due to the complex system of insurance, doctors and hospitals in conjunction with a lack of transparency, many individuals feel powerless to address these bills. However, there are methods to advocate for a fair and reasonable price to be negotiated. Some companies offer claim advocacy which do nothing more than try to negotiate down the bill. While, any reduction in the bill is wanted, Grady Legal takes a more aggressive approach. Grady Legal investigates the billing practices from a legal standpoint to ensure that all state and federal laws relating to contracts and consumer protection are adhered to.

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