KR Billing Solutions offer customized and advanced medical billing services. We believe in integrating innovation, experience, and expertise to help our clients accomplish the most and maximize their revenue. Our professional team members have a broad range of expertise in various medical fields and offer various services to help healthcare providers with their finances.
Patient billing or balance billing is a medical bill from a healthcare provider which bills a patient for the variation between the amount charged by the healthcare provider and the allowed amount. An example would be if the medical bill is $130 and the allowed insurance amount is $100, the healthcare provider may bill you for the remaining $30. The patient billing also occurs after you have paid your deductible, coinsurance, or copayment, and your insurance company has paid everything that it is obliged to for your medical bill. The remaining balance is thus paid by the patient.
Depending on the healthcare provider and the medical treatment or service you obtain, the healthcare provider may or may not bill you for covered services. Patient billing is largely done via billing software and medical billing services to automate processes to speed up the flow of revenue for healthcare providers. Patient billing involves numerous steps and varies for different healthcare providers and different states.
Patient billing also arises when a health care provider who is not in your insurance plan’s network charges more than your policy pays. Patient billing may also occur if the patient chooses to see a healthcare provider outside of the insurance plan’s network, such as a specialist. Although you cannot always avoid patient billing, you should take steps and understand your health insurance plan to reduce your chances of receiving a surprise bill.
One of the features of patient billing is that it is risky if you obtain healthcare services from out-of-network healthcare providers, thus you have to understand the difference between in-network healthcare providers and out-of-network healthcare providers.
In-network healthcare providers work together with insurance companies to negotiate and offer a specific discounted rate for their patients. Insurers are thus able to know the cost of medical care and services at these healthcare providers. You can find out the in-network healthcare providers on your insurance plan by checking your insurer’s website.
Out-of-network healthcare providers do not have an agreement with your insurance company or health plan regarding the cost of the medical services they provide. Payment from out-of-network healthcare providers may not be covered or partially covered by your healthcare plan and insurance company, leaving you prone to patient billing.
Patient billing also has several benefits to the healthcare industry as it reduces the free-rider healthcare problem and encourages patients to see the healthcare providers listed by their insurance companies. This is financially prudent for the healthcare and insurance industry as they can calculate and know the costs of medical treatment. Patient billing encourages responsible patient behavior in taking care of their health and reducing unnecessary medical treatments or services to prevent paying a higher cost.
KR Billing Solutions provides patient billing services that are transparent, fair, and comprehensive. We are committed to guiding healthcare providers in their billing services and in revenue management to ensure client and customer satisfaction.
If you have any questions about patient billing, you can call us at (855) 978-6499 or send us an email.