(09/18/2014) 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.
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