Balance billing

Balance billing is when your provider (for example, a doctor or hospital) bills you for more than the allowed amount (the dollar amount your health carrier has agreed to pay for health care services covered by your plan). A preferred provider (a doctor or hospital that has a contract with your health carrier to provide health care services to you at a discounted rate) is not allowed to balance bill you.

However, balance billing can occur when you receive health care services from a nonpreferred provider who has not agreed to a contract with your health carrier to provide health care services to you at a discounted rate.