In-Network
What does in-network mean?
In-network is a term often used in reference to healthcare providers and distinguishes a provider who has a contract with a health insurance plan. In-network providers may also be referred to as participating providers. Within this contract, the healthcare provider has agreed to provide their services to health plan members at a pre-negotiated rate.
This means that an in-network healthcare provider must accept the insurance plan as payment in full, as balance billing is not allowed for the patients.
Why is being in-network important for healthcare?
Since health insurance companies have already negotiated the cost of health services with in-network providers, patients typically pay a lower cost for these services than they would if they went to an out-of-network provider.
Some health plans only cover the cost of services for an in-network provider, whereas others may pay only some of the cost of out-of-network providers. Patients must check with their health plan to determine if they should adhere to in-network providers based on the coverage offered by their health plan.
In most cases, it costs more to see an out-of-network physician, which is why many individuals prefer to search for physicians included in their health plan’s network to minimize medical costs.