Out-of-network services may involve balance billing. What does balance billing mean?

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Multiple Choice

Out-of-network services may involve balance billing. What does balance billing mean?

Balance billing is when the patient ends up paying the difference between what the provider charges and what the insurer pays or allows for that service. For example, if a provider bills $300 and the insurer allows $200 to be paid, the patient may be billed the remaining $100. This often happens with out-of-network services, where the insurer’s negotiated rate doesn’t apply and the provider can charge the balance up to their billed amount. The other choices describe situations where the patient would either pay everything, nothing, or the payer covers everything, which aren’t what balance billing means.

Balance billing is when the patient ends up paying the difference between what the provider charges and what the insurer pays or allows for that service. For example, if a provider bills $300 and the insurer allows $200 to be paid, the patient may be billed the remaining $100. This often happens with out-of-network services, where the insurer’s negotiated rate doesn’t apply and the provider can charge the balance up to their billed amount. The other choices describe situations where the patient would either pay everything, nothing, or the payer covers everything, which aren’t what balance billing means.

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