Virginia Balance Billing

Virginia balance billing effective 1/1/21


For a non-participating provider, the member is responsible for any applicable deductible, coinsurance amounts stated in the member’s contract. For the following services you may not be balanced billed by the provider.


EMERGENCY SERVICES: from an out-of-network hospital, or an out-of-network doctor of other medical provider at a hospital.


NON-EMERGENCY SURGICAL OR ANCILLARY SERVICES: from an out of-network lab or health care professional at an in-network hospital, ambulatory

surgical center or other health care facility.


Additional information regarding your consumer rights can be found here.