Balance Billing

Balance billing is where the service provider charges a rate above that which is paid by a patient's medical aid.  The service provider then splits the patient's bill and expects the patient to pay in the difference.  Panacea is able to implement balance billing using Split Billing configurations .

It has often been claimed that balance billing is illegal.  However, Datamax has not been able to find any evidence to support this.  Some practitioners sign contracts with medical aids that preclude them from balance billing, but that is a voluntary matter between the parties.

The question "Is balance billing ethical?" is another matter.  Again, it is not Datamax's place to offer an opinion on that.  Please refer to the HPCSA  or your representative body for guidance on that.

Datamax will offer the following opinion, however:

Since you are free to charge what you like (within limits) and the medical aid is free to determine their own payout rates (subject to approval) then balance billing is a suitable compromise that should actually keep all parties happy.  But it is imperitive that the patient be informed upfront of your policy and that they consent to it.

The above is intended only as a discussion.  We are open to constructive criticism and suggestions.