Balance billing

Balance billing is when a provider bills you for the difference between the provider's charge and the allowed amount. HealthCare.gov gives an example: if the charge is higher than the allowed amount, the provider may bill you for the remaining part.

A preferred provider may not balance bill you for covered services. The problem mostly arises with an out-of-network dentist, who has not agreed to the plan's rates. NADP says this occurs when a provider is not in network.

Before treatment, ask the dental office for an estimate, and ask your plan how it treats out-of-network care. The UCR fee the plan uses can be lower than the dentist's fee. See in-network dentist and EOB.