Maryland Sample Letter regarding Bill
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How to fill out Sample Letter Regarding Bill?
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FAQ
Billing Time Statute You must submit a clean claim to the Maryland Medical Assistance Program within 12 months of the date of service (for acute hospitals?date of discharge). A clean claim is an original, correctly completed claim that is ready to process. Submit claims immediately after providing services.
State and federal law protects you from surprise or balance billing if you receive emergency care, including emergency behavioral health services at a medical facility or when you're treated at an in-network hospital or outpatient surgical facility by an out-of-network provider.
A hospital facility may not "balance bill" a Medicaid recipient for services for which the recipient did not knowingly agree to be responsible. Please refer any questions regarding this transmittal to the staff specialist for hospital services at (410) 767-1478.
Balance billing can happen when a patient receives covered health care services from an out-of- network provider or an out-of-network facility (a hospital, for example). In-network providers agree with an insurance company to accept the insurance payment in full, and don't balance bill.
Maryland-specific balance billing protections If you are in a PPO or EPO governed by Maryland law, hospital-based or on-call physicians paid directly by your PPO or EPO (assignment of benefits) may not balance bill you for services covered under your plan and can't ask you to waive your balance billing protections.
A balance bill is issued when a provider charges a patient with the amount the insurance company doesn't pay. For example, the dermatologist charges the insurance company $300. The insurance company agreed to pay $150. If the doctor then charges the patient the remaining $150, the patient will receive a balance bill.
