Health Care Corner: Tip by Monty Dise

Many people have a misconception of how out-of-network health insurance benefits work. While having out-of-network benefits is a good feature, the most important feature of provider networks is knowing the number of in-network participating providers your health insurer has. When using out-of-network benefits the consumer is commonly forced to pay a “balance bill” from their provider. A balance bill is the difference between what a provider charges a patient and what the insurance company reimburses the out-of-network provider as an allowable charge. This difference can sometimes be in the thousands of dollars. On the contrary, when a patient visits an in-network provider, the provider is bound to accept the insurance carrier’s allowable reimbursement limit, and therefore the patient is not faced with a balance bill. Buyer beware, it’s important to know your health insurance carrier’s network of participating providers.

Questions? Contact Monty Dise, President
Asset Protection Group, Inc.
mdise@apgroupin.com
804-423-7700

Independent Insurance Agents of Virginia