Balance billing is a billing practice that a doctor or healthcare facility will perform where they charge a consumer the difference between what they fully charge and what the insurance company chooses to reimburse. For example, if you visit a doctor and they charge $ 200, but your insurance company only pays $125, the doctor may bill you for the remaining balance of $75. Sometimes, a preferred in-network provider isn’t allowed to balance bill a consumer by the agreement they make with an insurance company but may do so anyway (by mistake.)
A few things to note regarding Balance Billing:
- Balance billing occurrences are on the rise within the USA.
- Balance billing complaints are rising exponentially.
- Balancing bill for emergency room services is common.
- Lawsuits due to balance billing are increasing.