Insurance and billing
Balance billing
Billing the patient for the difference between the office's fee and the amount the plan allowed.
Balance billing happens when an office charges the patient the difference between its full fee and the amount the insurance allows. In-network offices are generally barred from doing this for covered services under their contracts, while out-of-network offices often may. Know each plan's rules before sending a patient a bill, since billing an amount the contract forbids can cause complaints and compliance trouble.
Example at the front desk
We're out of network, so the amount above her plan's allowed fee is billed to her.