Short Description
The practice of billing a patient for the difference between the dentist’s full fee and the amount covered by insurance.
Long Description
Balance billing occurs when a dentist charges a patient the difference between their full fee and what the insurance plan has agreed to pay for a service. This typically happens when receiving care from an out-of-network provider, who is not bound by insurance-negotiated rates.
For in-network dentists, balance billing is generally prohibited because they have agreed to accept negotiated fees from the insurance provider. However, if a patient receives a service not covered by their plan, they may still be responsible for the full cost.
To avoid unexpected charges, patients should confirm their provider’s network status and ask for pre-treatment estimates to understand their financial responsibility before undergoing treatment.