What is Balance Billing?
Unity network providers charge a specific rate for services. This rate is the amount Unity pays for your care. This rate is known as the allowed amount.
When you get care from an out-of-network provider —
- They may charge more than Unity’s allowed amount.
- Unity compares this charge with other providers in the area for the same medical service. Unity uses this to find out the usual, customary and reasonable amount they will pay.
- If there is a difference between what the provider bills and the usual, customary and reasonable amount Unity pays, your provider may bill you for the difference. This is called balance billing and the amount charged doesn’t apply to your plan’s out-of-pocket costs.
To avoid being balance billed, try to see a doctor who is in Unity’s network. Go to
unityhealth.com/findadoctor to find a network provider. You may also call Unity Customer Service at 800.362.3310. TTY / TDD users, call 711 / 800.877.8973.