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What is Balance Billing?

Balance billing
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What is Balance Billing?

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Balance billing refers to The Department of Defense Appropriations Act of 1993, which states that a non-participating provider could not bill a beneficiary more than 115% of the TRICARE allowed amount.

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Balance billing is when a provider bills the patient for the difference between their charges and BCBSM’s approved amount. PPO network and participating providers will not bill for this difference. If you choose to see a non-network, nonparticipating provider, you are responsible for the difference. Nonparticipating providers do not have any agreements with Blue Cross Blue Shield of Michigan and have not agreed to accept our approved amounts for their services.

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