Orthodontic Appliance Wiki

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Balance Billing

Category: Insurance | Difficulty: Intermediate | Priority: Nice-to-know

Clinical Definition

Billing a patient for the difference between a provider's charge and the plan's allowed amount when the provider is not required to accept the allowed amount as payment in full.

Patient-Friendly

When a provider bills you for the leftover difference after your plan has paid what it will pay.

Related Terms

[[out-of-network; allowed amount; ucr]]

Notes

Many in-network providers agree not to balance bill for covered services under contract

Audience

๐Ÿ—‚ Front Desk