NSCLC: What Should California Advocates Do If Their Clients are Balance Billed?

St. Barnabas Senior Services Adult Day Center

When medical providers bill  dual eligible beneficiaries (those with both Medicare and Medi-Cal) for charges not covered by either Medicare or Medi-Cal; or Medi-Cal only seniors and persons with disabilities any amount for a Medi-Cal covered service, it’s called Balance Billing. This practice violates both state and federal law, but some providers don’t know they are breaking the law and engage in balance billing anyway. As beneficiaries transition to managed care under the Coordinated Care Initiative, instances of balance billing may increase.

Intended for advocates, this fact sheet supplements an earlier National Senior Citizens Law Center Health Network Alert about balance billing, offering advocates concrete steps they can take if their clients are balance billed. It provides additional resources and includes hypothetical situations in order to illustrate different ways that balance billing can occur.

Please click here for fact sheet: http://dualsdemoadvocacy.org/wp-content/uploads/2014/09/Balance-Billing-in-California.pdf

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  • LAAAC is managed by St. Barnabas Senior Services; Funded, in part, by Archstone Foundation.
  • St. Barnabas Senior Services

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