CommercialReimbursementMedium impact
Reminder: do not balance bill for hearing aids
Harvard Pilgrim Health Care·Audiology, ENT (Ear, Nose & Throat)·Reimbursement
We identified it
Jun 20, 2026
Summary
Harvard Pilgrim and Point32Health are reinforcing their prohibition on balance billing for hearing aids after identifying provider errors. Providers can only collect contracted allowed amounts plus patient cost-sharing, not additional amounts based on benefit limits or full charges.
Action Required
Immediately: Review all hearing aid billing procedures to ensure no balance billing occurs. Only collect contracted allowed amounts plus patient cost-sharing (copays, coinsurance, deductibles). Train billing staff to distinguish between benefit limits and contracted allowed amounts. Update billing system alerts to prevent charging beyond contracted rates for Harvard Pilgrim/Point32Health members.