Q: In-network Dr balance billing me. I’m receiving ins settlement from other driver in accident. Is this legal in Indiana?
For 2 years Dr billed my insurance. I paid co-pays + 20% of my portion. Insurance paid contractual amount the entire 2 years. Asked billing what I owed to be paid thru settlement - they gave me a total of $265 owed. The same total was reflected on my online portal for a balance owed. When it was time to pay that balance they came back with a balance billing of $9,769 owed bc I was getting a settlement from the other drivers insurance. That’s the amount between what insurance paid to the total billed. They said it’s insurance money not my money. Is this legal in Indiana? Is there a website/resource to find IN state laws that address balance billing?
A: If you are settling you need to review this with your attorney. If you don't have an attorney, review it with a member of the Indiana Assn for Justice--they give free consultations. Generally, they can be held to the billing you relied on. Also, assuming insurance paid them, it's not the doctor that should get the balance but the insurance company if anything. This sounds quite shady. If you have doubts, file a complaint with the health department.
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