Common use of Balance Billing Clause in Contracts

Balance Billing. No claim for payment, except for co-payments, deductibles, and co-insurance, will be made by the Contractor or Provider from the Enrollee for a service covered under this CHIP contract. The Contractor and Provider will not balance bill the Enrollee for dental costs covered under the CHIP contract. The Provider will consider the reimbursement from the Contractor plus co-payments, deductibles, and/or co-insurance as payment in full for dental costs. For costs in excess of the $1,000 benefit limit, Providers shall continue to bill clients at the contracted rate according to the restrictions set forth in Attachment B, section 10.4.2. Clients will have the responsibility to pay those costs only if the requirements of Attachment B, section 10.4.2 are followed.