How to Avoid Balance Billing and Maintain Patient Trust
                     HOW TO AVOID BALANCE BILLING AND MAINTAIN PATIENT TRUST
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HOW TO AVOID BALANCE BILLING AND MAINTAIN PATIENT TRUST
Balance billing happens when a patient is billed for the remaining portion of a medical 
bill after their insurance has paid its share. This typically occurs in cases where the 
provider is out of network, resulting in higher charges than what the insurance plan 
covers. For example, if a medical bill is $1,000 and insurance covers only $700, the 
provider may attempt to bill the patient for the remaining $300, leading to balance 
billing.
The practice of balance billing is not just a financial burden for patients but 
also a legal and reputational risk for healthcare providers. To mitigate these 
risks, healthcare organizations need to avoid common mistakes and adhere to 
both federal and state regulations.
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Balance Billing Mistakes & How to Avoid Them?
1. Violating Legal Protections
Healthcare organizations often make the mistake of ignoring or misunderstanding the 
legal protections designed to prevent balance billing. One such protection is The No 
Surprise Act, a federal law prohibiting balance billing for emergency services, regardless 
of whether the provider is in-network or out-of-network. Additionally, the act limits out-
of-network charges when services are provided at in-network facilities in non-emergency 
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situations.
HOW TO AVOID BALANCE BILLING AND MAINTAIN PATIENT TRUST
In fact, violating these protections can lead to legal action, fines, and reputational 
damage. Patients who are improperly billed may lose trust in the organization and take 
their business elsewhere. Thereby, healthcare providers must stay updated on federal 
and state regulations regarding balance billing. In fact, compliance with The No Surprise 
Act and state laws is essential to avoid legal and financial repercussions. Providers 
should regularly review these protections and ensure that all staff are well-versed in 
them.
2. Absence of Clear Communication
Another common mistake is the lack of transparency in communicating potential costs 
to patients before they receive medical services. Patients may not fully understand their 
insurance coverage or the possibility of out-of-network charges, which can result in 
surprise medical bills. This can lead to patient confusion and frustration, damage trust, 
and cause negative experiences.
Clear and transparent communication is key. Before providing any services, verify the 
patient’s insurance coverage and explain any potential costs they might incur. There is 
also a need to provide written documentation detailing the billing process, insurance 
coverage, and out-of-network fees. This will help patients make informed decisions and 
reduce the chances of surprise bills.
3. Inaccurate Coding and Billing
Mistakes in medical coding or billing errors are other frequent causes of inflated bills, 
which can lead to balance billing issues. Improperly coded claims can result in 
confusion among patients, who may feel overcharged or wrongfully billed. In fact, 
inaccurate billing can damage theHT ToPrSg://aWnWiWz.2a4t7iMoEnDI’CsA LfiBInLLaINnGScEiRaVlI ChEeS.aCOltMh/    and lead to audits or 
legal investigations.
HOW TO AVOID BALANCE BILLING AND MAINTAIN PATIENT TRUST
4. Ignoring Insurance Contractual Agreements
Healthcare organizations often fail to review and adhere to insurance contractual 
agreements outlining how balance billing should be handled. Ignoring these agreements 
can lead to legal issues and strained relationships with insurance companies. Not only 
this but non-compliance with insurance contracts can result in denied claims, financial 
losses, and reputational damage.
Therefore, there is a need to regularly review insurance contractual agreements and 
ensure that your billing practices align with them. Designate a staff member to monitor 
coverage and reimbursement rate changes and communicate updates to the rest of the 
team.
5. Inadequate Staff Training
A lack of proper staff training on billing procedures is another common mistake that can 
lead to balance billing issues. Staff who are not well-versed in the latest regulations or 
insurance guidelines may inadvertently make billing errors. In fact, well-trained staff can 
increase the likelihood of errors, harming patient satisfaction and leading to financial 
instability.
The ultimate solution to such a challenge is to invest in ongoing training for all staff 
members involved in the billing process. This includes front desk personnel, billing 
specialists, and administrative staff. Regular training sessions will ensure that your team 
knows the latest rules and regulations regarding balance billing.
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HOW TO AVOID BALANCE BILLING AND MAINTAIN PATIENT TRUST
Outsourcing as a One-stop Solution for Maintaining Patient Trust
Outsourcing billing services to 24/7 Medical Billing Services offers healthcare 
organizations an effective way to avoid balance billing mistakes and maintain 
patient trust. These providers bring specialized expertise in medical billing and stay 
updated on federal and state regulations, such as The No Surprise Act, ensuring 
compliance and reducing costly errors. Using advanced software and automated 
processes, they improve billing accuracy, minimizing the risk of balance billing and 
enhancing the overall patient experience. Moreover, outsourcing companies often 
provide patient support services, helping patients understand their bills and 
insurance coverage. This transparent communication fosters transparency and 
builds trust.
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HOW TO AVOID BALANCE BILLING AND MAINTAIN PATIENT TRUST
About 24/7 Medical Billing Services:
24/7 Medical Billing Services is the nation’s leading medical billing 
service provider catering services to more than 42 specialties across 
the entire 50 states. You can rely on us for end-to-end revenue cycle 
management. We guarantee up to 10-20% increase in the revenue 
with cost reduction of your practice for up to 50%. 
Call us today at 888-502-0537 to know more on how we can help 
boost profitability for your practice.
Media Contact:
24/7 Medical Billing Services,
Georgia:
3001 Greenfield Drive, Marietta GA, 30068
Texas:
2028 E Ben White Blvd, #240-1030 Austin TX, 78741
Tel: + 1 -888-502-0537
Email - [email protected]  
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