Balance billing is a provider billing you for the difference between the billed amount and the allowed amount. Allowed amount is the most the plan pays for a specific covered service or supply.
For example, if the billed amount is $100 and the allowed amount is $70, the provider may bill you for the remaining $30.
- For UMP Achieve 1, UMP Achieve 2, UMP Classic, UMP CDHP, and UMP High Deductible: Preferred and participating providers may not balance bill you for covered services above the allowed amount.
- For UMP Plus (PEBB and SEBB): ACP network and other Blue Cross and/or Blue Shield providers may not balance bill you for covered services above the allowed amount.
See an example of how this works in your certificate of coverage.