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To comply with the Idaho Patient Act, healthcare providers must ensure the following requirements are satisfied: Provider must submit charges to patient or insurance within 45 days.
Essentially, an HCP has 90 days to submit the bill and still use extraordinary collection actions. The only difference is that after the first 45 days, an HCP cannot shift any of the costs and fees of extraordinary collection actionsto the patient.
Steps to Fight Against Balance BillingReview the Bill. Billing departments in hospitals and doctor offices handle countless insurance claims on a daily basis.Ask for an Itemized Billing Statement.Document Everything.Communicate with Care Providers.File an Appeal with Insurance Company.
Is Balance-Billing Legal? Unless there is an agreement to not balance bill or state law specifically prohibits the practice (which are quite rare), medical providers may bill patients for any amounts not paid by insurance.
The Department of Insurance can help Idahoans understand and utilize these new consumer protections, regardless of whether they have health insurance. The new law prevents health care providers from surprise balance billing in emergency, and some non-emergency situations, among other protections.
The Act requires only the submission of charges to third-party payors identified by patient, or to the patient where no payor is identified. Third party payor is a defined term and includes a health carrier, as defined in IC 41-5903, or a self-funded plan, as defined in IC 41-4002 or 41-4102.
The standard repayment time for a medical billwhether you receive it on time or notis 30 days. That being said, every provider or hospital is different, so make sure you check with them to see what the allowable payment timeframe is.