What does 'balance billing' involve?

Balance billing refers to the practice of charging a patient for the remaining amount owed after insurance has processed a claim and made a payment. This situation typically occurs when a healthcare provider's fees exceed the amount the insurance company is willing to pay. For example, if a provider charges $200 for a service, and the insurance company pays $150, balance billing would involve the provider seeking to collect the remaining $50 directly from the patient. This can raise compliance issues, particularly if the patient was not adequately informed of the balance billing policies beforehand, especially in cases involving out-of-network providers or certain types of insurance plans that may restrict this practice.

The other options do not accurately describe balance billing. Providing discounts for early payments is unrelated to the collection of unpaid balances after insurance payment. Billing multiple insurers for the same service is known as double billing and is considered fraudulent. Unbundling services involves coding multiple aspects of a single service separately to increase reimbursement, which is a different practice entirely.