What is health insurance balance billing? | Patriot Plans
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HomeHealth InsuranceWhat is health insurance balance billing?
Health Insurance Basics

What is health insurance balance billing?

Balance billing occurs when an out-of-network provider bills you for the difference between their charge and what your insurance paid. The No Surprises Act (effective 2022) protects patients from unexpected balance bills for emergency care and certain other services from out-of-network providers.

Key Points

  • Balance billing: out-of-network provider bills you for the difference
  • No Surprises Act: protects patients from unexpected balance bills
  • Protections apply to: emergency care and certain out-of-network services
  • In-network providers: cannot balance bill
  • An independent agent can help you understand balance billing protections