What does the term "balance billing" mean?

Balance billing refers to the practice where a healthcare provider bills the patient for the difference between the amount the insurance company pays and the total amount billed for a service. This typically occurs when a patient receives care from an out-of-network provider, meaning that the provider does not have a contract with the patient's insurance company. Since the insurer often pays less for out-of-network services, the provider can seek the remaining balance directly from the patient. This practice can lead to unexpected costs for patients who may not be fully aware of the billing terms or who thought their insurance would cover a greater portion of their medical bills.

The other options do not accurately represent the concept of balance billing. Insurers paying the entire bill would mean that the patient would not see any additional charges, which is contrary to balance billing. Billing only for services within network prices refers to in-network situations where patients typically have lower out-of-pocket expenses, thus not involving additional charges beyond what the insurer covers. Lastly, a system to calculate billing errors is unrelated to the concept of balance billing; it pertains to resolving discrepancies in billing rather than charging patients for the balance owed after insurance payments.