Balance Billing
The practice of a provider billing you for the difference between their charge and the allowed amount by your insurance plan. This usually happens with out-of-network providers.
Detailed Explanation
Balance billing can lead to unexpected and often high medical bills. It's important to understand your plan's network and whether your state has protections against balance billing.
Practical Example
Imagine Tom went to an out-of-network emergency room with severe chest pain. The hospital billed him $5,000, but his insurance company only paid $2,000 based on their allowed amount. Tom might receive a bill for the remaining $3,000, which is balance billing.
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