It is something that has likely happened to many Mississippians that have health insurance. You go to the doctor, get a bill, and insurance pays for a portion of it. A short time after, you receive a bill for the remaining balance owed to the healthcare provider. This is a practice that is known as balance billing, and it is prohibited in Mississippi.
The law states that when a healthcare provider accepts an insurance payment, even if that payment was only for a portion of the bill, the provider must consider the invoice as paid in full. For patients that see healthcare professionals within the network their insurance company allows, this is not usually a problem. It is when patients unknowingly see a healthcare professional outside of their network that it becomes an issue.
Anesthesiologists for example, often bill separately from the hospital they work out of. If they accept a patient’s partial insurance payment, they then often bill the patient for the remaining balance. Anesthesia is very costly and sometimes these bills are thousands of dollars and can financially cripple a person when they thought they were covered.
“Patients have to start looking closely at their bills and insurance payments and know what they are required to pay, and what they are not,” says Christopher Van Cleave of Van Cleave Law. “Challenging the bill is possible, and patients are the only ones that can do it.”
While balance billing is illegal in Mississippi, it still happens all the time and there is currently no way to enforce the law against the practice. Often though, all a patient has to do is bring the illegality of the balance bill to the attention of their healthcare professional. In most cases, healthcare providers are also unaware that they are breaking the law. Once they realize they are, they will usually withdraw the bill.
Although this is good news for patients, they also must remember that the law only applies if the provider has accepted a partial insurance payment. If insurance did not cover any of the treatment, the patient must still pay the bill in full, or they will be the ones found in violation of the law.