Question

Describe the difference between "in-network" and "out-of-network" provider.

Answer 1

THIS IS FOR PPO PLANS ONLY
In-network: You go to a doctor and the total charge is $250. You get a discount of $75 because you went to an in-network doctor and our negotiated rate with them is lower. We pay $140. You pay what’s left, which is $35.
Out-of-network: You go to a doctor and the total charge is $250. You won’t get a discount because the doctor is out-of-network. We still pay $140, but you’ll be responsible for what’s left, which is $110. We call this balance billing.

Going out-of-network could mean you'll have to pay a larger percentage of the cost or the total cost, depending on your particular plan. You may also pay a higher coinsurance percentage and have higher annual coinsurance and out-of-pocket maximums.

Answer 2

i just described it for you perfectly idk what else you want

Answer 3

here is a simpler example:
An in-network provider is one contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates.
An out-of-network provider is one not contracted with the health insurance plan.

Answer 4

I got it lol i was watching a movie sorry lol.

Answer 5

Thanks ill give u a medal :)

Answer 6

oh ok :))