Health Insurance: What is balance billing?

Health Insurance:  What is balance billing?

•If a provider is out of network, the insurance company will pay them the out of network rate.

•The provider can bill you the difference -There is no limit on what they can bill you.

•With private equity buying practices, some are actively staying out of insurer’s networks so they can balance bill the patient.   

- source- Dr Carolyn McClanahan - NAPFA Connect May 2020

 States with balance billing protection                         Source: Commonwealth Fund

If your state has no balance billing protection:

•Make your standard question when you get care –Is this in network?                 –Document the communication

•If admitted to the hospital –put a sign over your bed saying, “PROVIDE IN NETWORK CARE ONLY”

–Have someone take a picture of you in your bed for documentation.