HNS Policy 

 

HNS providers may only collect the applicable co-payment, deductible and/or co-insurance for any covered service provided.

 

HNS providers may not collect more than the HNS contracted allowable for any covered service provided.

 

For this policy, balance billing is defined as the practice of billing a member in excess of any applicable co-payment, co-insurance/deductible.

 

While providers can and should collect all applicable co-payments, co-insurance and deductibles, providers cannot "balance bill" the patient for the difference between the providers usual and customary charge and the contracted allowable amount.

 

The signing of a "waiver" does not allow a provider to "balance bill" a patient for covered services provided.

 

"Balance billing" should not be confused with billing for services that are not covered under the member's plan. All network providers may provide and collect their usual and customary fee for any non-covered services, provided they have first obtained a signed waiver from the member. Please remember the waiver cannot be generic and must specifically state the service/supply recommended, as well as the actual costs of the services. All waivers must be maintained in the member's healthcare record.

 

Please click Non-Covered Services Waiver for a sample template that can be customized for use by any HNS provider.