 [ Symptoms ] what are your legal obligations to pay your doctor for treatment above and beyond what your insurance will pay [ Disease ] it depends on the doctor is relationship with the insurance company  says richard e ungar a los angeles based health care attorney that relationship can make the difference between balance billing not allowed and billing you for a balance you owe completely kosher is your doc in or out a health care provider who is in network with your insurance company has negotiated a price for his or her medical services and signed a contract with your insurer agreeing to those rates as payment in full with the exception of your co pay deductible or coinsurance in network providers generally cannot charge you more for their services doing so is considered balance billing whether or not you have signed a form stating you will pay the balance of what your insurer will not but that is not the end of the story there are scenarios in which you may be required to pay beyond what your insurance company will even if the doctor is in your carrier is network duped by details there are details consumers commonly overlook about the rules of their insurance coverage that cause trouble says marty rosen executive vice president and co founder of health advocate a healthcare advocacy and assistance organization forgetting the common requirement to pre certify services before receiving care is a frequent mistake another is not confirming ahead of time whether you are being treated by doctors in your insurance carrier is network failure to do so may result in denial of coverage by your insurance company and thus large out of pocket fees  rosen says also watch for certain elements of a doctor is visit that your insurance coverage may not cover ungar warns for example let is say you see an in network doctor for a routine colonoscopy both the doctor visit and the procedure may be fully covered by your insurer but if your doctor decides to use a newer sedative that requires an anesthesiologist to administer it as opposed to doing it herself unger says you could be on the hook for the anesthesiologist is charges in order to avoid unnecessary health care costs before you get care * make sure the service you need is covered * determine exactly what the contracted service includes * confirm that the doctor is in your network and do not sign any documents you do not understand or do not feel comfortable with