Balance Billing
Insurance Glossary
A provider billing a patient for the difference between what it charged and what the health plan allowed, on top of any deductible, copay or coinsurance. In-network providers agree by contract not to do it, so it generally arises with out-of-network care. The federal No Surprises Act bars it in several situations, including emergency care and treatment by out-of-network providers working at in-network facilities, and a number of states add their own protections.
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