Balance Billing

Updated: 29 February 2024

What Does Balance Billing Mean?

Balance billing refers to a health professional or health facility charging the insured for treatment beyond what their health insurance has already paid. This usually occurs for treatment from a physician, clinic, or hospital that is outside the insurer's network.

Insuranceopedia Explains Balance Billing

The usual scenario is that of an insured paying out-of-pocket because the cost of treatment goes beyond the insurance coverage. Balance billing, though, has become controversial because of cases in which the insured are surprised by the amount of money that they have to pay after getting treatment from a healthcare provider that they didn't realize was out of network.

Go back to top