What does 'Balance Billing' typically involve?

Balance billing typically involves billing a patient for the amount of services that go beyond what their insurance company pays. This means that after the insurance has processed a claim and paid its share, the provider seeks additional payment from the patient to cover the remaining balance.

In many situations, particularly out-of-network services or providers, this practice allows healthcare practitioners to collect the full cost of the service, as they might not be constrained by the payment agreements that apply to in-network providers. Balance billing can sometimes raise ethical and legal concerns, particularly when patients are not fully informed about their financial obligations beforehand.

Understanding balance billing is important in the context of health care finance because it directly impacts patients' out-of-pocket expenses and their overall experience with healthcare costs.