Balance Billing

The attorneys at Silver & Silver P.A. are vigilant when it comes to protecting our clients’ rights. It has come to our attention that some medical providers are engaged in a practice known as “Balance Billing” in an attempt to take advantage of injury victims. “Balance billing” often occurs secondary to an automobile accident after a medical provider such as a hospital, ambulance or doctors office, submits its bills to a PIP carrier. If the bills exceed the “Allowable” amount then the PIP carrier will reduce the bills. The violations occur when the medical provider thereafter submits a bill to the patient or to the patient’s attorney for the difference between the “Billed” amount and the amount paid. This practice is known as “Balance Billing.” Balance billing by medical providers is regulated by Florida law and, in many cases, by the provider’s contract with the insurance company.

In the case of private health insurance, for example, companies negotiate special rates with medical providers. In exchange for making concessions on their rates, the providers are added to the insurance company’s network. Being “in-network” gives the providers a much better chance of being chosen by a policyholder requiring care in the provider’s area of specialty. Violations can occur when providers bill the policyholder for an amount beyond that allowed by the contract.

Many patients are not aware of their rights in these matters and pay bills that are not their responsibility. If you think that you may have overpaid a medical bill for medical or healthcare treatment rendered to you by a hospital, ambulance, physician or any other medical provider, , you may have grounds to pursue legal action against the medical provider. These are complex legal matters, and it is important that you seek the advice of a qualified lawyer with the ability to protect your interests.

Is Balance Billing Legal in Florida?

Balance billing is illegal in Florida in many situations. In April 2016 Governor Rick Scott signed a bill outlawing the practice of balance billing. This law applies not only to those who are involved in car accidents but also people who inadvertently receive out of network benefits on their in-network insurance plans. This law protects anyone injured in a car accident as well as someone who goes to a doctor or hospital.

Medical Liens And Letters Of Protection

When medical providers are treating a patient for an injury suffered in an auto accident or another incident that might result in an award of damages, many will refuse to submit their bills to the insurance company for payment. Instead, they will attempt to place a lien on the recovery or ask the patient to sign a letter of protection (LOP) in order to get more money for their services.

In most cases, patients are not aware that bills are not being submitted to the insurance company or that the provider is planning to take a large portion of their recovery to cover medical expenses. Speak with an attorney who can help you understand your rights and take the necessary steps to protect you.

Learn More About Your Rights And Legal Options

At the personal injury law firm of Silver & Silver, P.A., we are currently reviewing cases for individuals whose rights have been violated by a medical provider. Contact our South Florida Personal Injury Firm today to discuss your balance billing concerns with a lawyer.

Call Now Button