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  1. Ask Toyon
  2. CARES Funding FAQ
  3. Provider Relief Fund General Information
  4. Balance Billing

Balance Billing

  • How will a provider know the in-network rates to be able to comply with the requirement to bill a presumptive or actual COVID-19 patient for cost-sharing at the in-network rate?
  • How does HHS define a presumptive case of COVID-19?
  • Balance billing suggests that providers that provide out-of-network care to an insured, presumptive or actual COVID-19 patient can bill the patient’s insurer any amount, as long as they do not bill the patient directly. Is that correct?
  • Do the Terms and Conditions for the General and Targeted Distributions require attesting to a ban on balance billing for all patients and/or all care, because “HHS broadly views every patient as a possible case of COVID-19”?
  • How should dental providers comply with this requirement: recipient will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if in-network?
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