If a Medicare Private Fee-for-Service Plan’s provider (doctor or hospital) charges you for more than the plan’s payment amount for services, this is called balance billing. This overcharge cannot be more than 15% of the amount approved by Medicare. Depending on your state, balance billing could be less than 15%. In order to balance bill the provider needs to have a written contract with the Medicare Private-Fee-for-Service Plan or who have met certain company conditions to ensure a contract.
Even though the Plan allowed providers to “balance bill,” the provider still accepted the Medicare-approved amount as payment in full.