Health Insurance How-To: Avoid Balance Billing

September 8, 2020
Health Insurance How-To: Avoid Balance Billing

If you use an out-of-network provider, you might end up with a much larger bill than you expected. This is because of a practice called balance billing.

Balance billing is when a medical provider who is not in the QualChoice network bills you for charges above what QualChoice pays for out-of-network services. And care from an out-of-network (OON) provider, even if given at an in-network (INN) doctor’s office or facility, may be very costly. This is because the OON provider is not required to accept the QualChoice contracted rate. You could end up owing a lot more than you planned to pay.

We can’t protect you from balance billing since there is no cap on what an out-of-network provider may charge. So protect yourself from financial hardship. Make sure all doctors and other health experts involved in your care are in your network. This means specialists (like anesthesiologists), medical equipment providers and lab or x-ray testing, and others.

So remember, your QualChoice benefits will be higher for in-network care. And you won’t get a scary bill from the provider!

How to Find an In-Network Provider

  • At, click on Find a Doctor or Hospital.
  • Search for the type of doctor or facility you need.
  • Check your QualChoice ID card for your network name.
  • Make sure ALL providers are in your network.

For help call Customer Service Monday through Friday, 8:00 a.m. to 5:00 p.m., at 800.235.7111 or 501.228.7111.