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State Insurance Division Warns Consumers Of Balance Billing
PIERRE — The South Dakota Department of Revenue & Regulation, Division of Insurance is advising consumers to carefully review the bills they receive from their medical providers to ensure they are not being overcharged due to balance billing.
Balance billing occurs when a medical provider has contracted to provide services to a consumer and then charges the patient over and above the amount they agreed to in the contract. It includes any billing for covered services above and beyond the coinsurance, copayment and deductible in a patient’s policy or plan. Estimates indicate consumers pay $1 billion or more a year for bills they are not responsible for due to balance billing. Insurance Division Director Merle Scheiber says keeping a close eye on your medical bills can help you avoid paying more than you should.
Scheiber says one way to determine if your medical provider has agreed to accept a contracted amount and cannot balance bill is to find out if your insurance policy or employer plan has a network. If they do, and your medical provider is part of that network, it is safe to assume that the provider has agreed to charge only the contracted amount.
Individuals who find they are being balance billed should contact their provider or insurance company to point out any billing errors. As South Dakota state law prohibits balance billing, consumers should also contact the South Dakota Division of Insurance for assistance at 605-773-3563 or by email at insurance@state.sd.us.
Balance billing occurs when a medical provider has contracted to provide services to a consumer and then charges the patient over and above the amount they agreed to in the contract. It includes any billing for covered services above and beyond the coinsurance, copayment and deductible in a patient’s policy or plan. Estimates indicate consumers pay $1 billion or more a year for bills they are not responsible for due to balance billing. Insurance Division Director Merle Scheiber says keeping a close eye on your medical bills can help you avoid paying more than you should.
Scheiber says one way to determine if your medical provider has agreed to accept a contracted amount and cannot balance bill is to find out if your insurance policy or employer plan has a network. If they do, and your medical provider is part of that network, it is safe to assume that the provider has agreed to charge only the contracted amount.
Individuals who find they are being balance billed should contact their provider or insurance company to point out any billing errors. As South Dakota state law prohibits balance billing, consumers should also contact the South Dakota Division of Insurance for assistance at 605-773-3563 or by email at insurance@state.sd.us.
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