What is billing balance in healthcare?

Answer 1

I want to make sure that this question is answered correctly. There are 2 ways to look at "billing balance" in Healthcare,

"Balance Billing" is the first and most common way to see this. It is the practice of billing the patient the amount left on a claim after ALL the insurance, primary, secondary, etc. has paid their portion. For many insurances, such as Medicare, balance billing is not permitted unless the amount billed is related to the yearly deductible or coinsurance. With A Medicare Advantage plan, it can only be the deductible and co-pay.

"Billing balance" is billing the patient the money left after all payments have been applied. This is the patient's statement. However, this bill should not go out until the insurance payments have been exhausted and the EOBs and RAs have clearly explained why the patient owes this amount.