Balance billing occurs when the provider bills the patient for the difference between the provider's charge and the allowed amount.

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Multiple Choice

Balance billing occurs when the provider bills the patient for the difference between the provider's charge and the allowed amount.

Balance billing is when the provider charges the patient the remaining amount after the insurer has paid its portion, i.e., the difference between the provider’s charge and the amount the insurer allows. This exactly matches the statement that the provider bills the patient for the difference between the provider's charge and the allowed amount. The other scenarios describe situations where either the patient owes nothing beyond their copay/coinsurance/deductible, or the insurer bills the patient for non-covered charges, or the provider and insurer agree to a discount, none of which constitute balance billing.

Balance billing is when the provider charges the patient the remaining amount after the insurer has paid its portion, i.e., the difference between the provider’s charge and the amount the insurer allows. This exactly matches the statement that the provider bills the patient for the difference between the provider's charge and the allowed amount. The other scenarios describe situations where either the patient owes nothing beyond their copay/coinsurance/deductible, or the insurer bills the patient for non-covered charges, or the provider and insurer agree to a discount, none of which constitute balance billing.

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