What happens if the beneficiary is mistakenly billed for the entire amount of the claim?
If we are notified of an insurance where a non-participating provider is balance billing a beneficiary, we will contact the provider to educate them on the balance billing requirement and the total amount the beneficiary has to pay. We will also inform the provider to cease billing of the beneficiary. If the non-participating provider continues to bill the beneficiary, the provider can be excluded from the TRICARE program. In this case, the provider will also be excluded from other governmental programs such as Medicare and Medicaid.
Related Questions
- What is needed from an attorney or claim adjuster to release the amount medicaid paid for medical treatment to a beneficiary who was involved in a vehicular accident?
- What happens when the insurance company sends the payment for a claim to the patient rather than the provider? Can we bill the patient the entire amount?
- What happens if the beneficiary is mistakenly billed for the entire amount of the claim?
