Question

Balance billing may be illegal when done by a a. participating provider. b. hospital. c. billing service. d. free-standing diagnostic laboratory.

Answer 1

The correct answer is A

Participating provider

This is a term that alludes Doctor's capacity to bill the patient for the balance of the sum for the medicinal administration gave after the insurance organization has paid its offer.

At the point when a provider of medical services is a piece of an insurance network, at that point it consents to offer discounted rate and accordingly balance billing won't happen. Anyway out-of-network specialists are not bound by such concurrences with insurance organization. They can charge the maximum, and the insurance organization on their part will choose how much they will permit to be reimbursed for such medical services got from such out of network Doctors.

In this manner it will be an unlawful activity if a participating specialist goes for Balance Billing by charging full balance sum without offering any rebate as clarified previously.