administration

Balance Billing

差額請求 (sagaku seikyū)

Balance billing occurs when an out-of-network provider bills a patient for the difference between their charge and the amount the insurer pays, in addition to any required cost-sharing. For example, if a provider charges $1,000 and the insurer pays $600, the provider may attempt to bill the patient the remaining $400 'balance.' The No Surprises Act (effective 2022) bans balance billing in most emergency situations and for certain non-emergency services by out-of-network providers at in-network facilities.

Patients who receive a surprise balance bill should contact their insurer and can file a complaint with the CMS No Surprises Help Desk.

In 9 languages

Language	Term
English	Balance Billing
Japanese (日本語)	差額請求
Chinese (中文)	差额账单
Korean (한국어)	차액 청구
Portuguese	Cobrança do Saldo
Spanish	Facturación del Saldo
Filipino	Balance Billing
Thai	การเรียกเก็บเงินส่วนต่าง
Vietnamese	Hóa đơn số dư
Romanization	sagaku seikyū

Related terms

• In-Network Provider ネットワーク内プロバイダー
• Out-of-Network Provider ネットワーク外プロバイダー
• Surprise Bill サプライズ請求

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