Balance Billing

What Does Balance Billing Mean?

Balance billing occurs when a healthcare professional or facility charges the insured for treatment costs exceeding what their health insurance has already covered. This typically happens when the treatment is provided by a physician, clinic, or hospital outside the insurer’s network.

Insuranceopedia Explains Balance Billing

The typical scenario involves an insured individual paying out-of-pocket when the cost of treatment exceeds their insurance coverage. However, balance billing has become controversial due to cases where the insured are unexpectedly charged large amounts after receiving treatment from a healthcare provider they did not realize was outside their network.