when you receive care from a provider that is part of the AHS State Network. Providers who participate in the AHS State Network agree to pre-negotiated fees. You receive a higher benefit if you participate In-Network.
A provider, hospital, pharmacy, or other facility is "in-network" when it has contractually accepted the health insurance company's terms and conditions for payment of services.
Refers to the use of providers who participate in the Health Benefit Plan's Provider Network. Many Health Benefit Plans require Members to use participating (in-network) Providers to receive Benefits or the highest level of Benefits.
Refers to the use of providers who participate in the health plan's provider network. Many benefit plans encourage enrollees to use participating (in-network) providers to reduce the enrollee's out-of-pocket expense.
This refers to services performed by a group of physicians who have a contract or agreement with the insurer to provide specific services for a specific fee.
You receive treatment from the doctors, clinics, health centers, hospitals, medical practices, and other providers with whom your plan has an agreement to care for its members. Examples include a Fee-For-Service plan's PPO or a Health Maintenance Organization. Members have fewer out-of-pocket costs when they use in-network providers.
A Service provided by a doctor, dentist or other provider who has a contract with a members insurance plan.
describes a provider or health care facility which is part of a health plan's network. When applicable, insured individuals usually pay less when using an in-network provider.
Any professional person, organization, health facility, hospital or other person or institution licensed and/or certified by the State or Medicare to deliver or furnish healthcare services and who is contracted directly with Secure Health or engaged by an IPA to provide benefits to members.
Health-care facilities or providers that are under contract with a carrier.
Providers or health care facilities which are part of a health plan's network of providers with which it has negotiated a discount. Insured individuals usually pay less when using an in-network provider, because those networks provide services at lower cost to the insurance companies with which they have contracts.
CLOSE The term "In-Network" refers to physicians and other health care professionals who are in your plan. In many plans, the amount you pay is less than if you go to an "Out-of-Network" doctor."In-Network" estimated expenses includes only in-network services. No mixing of in-network and out-of-network services is assumed.
when the participants choose to receive care from providers who participate in a network under the plan, this is considered receiving care "in-network." Some plans have a "gatekeeper" who must authorize all care to have that care covered at in-network levels under the plan.
the use of, and referral to, Participating Providers to obtain healthcare services.
Refers to the use of Providers who participate in the insurance company's Provider Network. Many Benefit plans encourage Members to use Participating (In-Network) Providers to reduce the Member's Out-of-Pocket expense.
Benefits are maximized when you use in-network providers (i.e. CareFirst PPN or UCCI POS). In-Network providers have agreements with health insurance companies to accept the health insurance companies payment for services rendered along with your co-payment.
Refers to the use of providers who participate in provider network. Use of a participating (in-network) provider may reduce the enrollee's out-of-pocket expense.
Services provided by a contracted provider in accordance with all plan requirements.
Some insurance plans require that you receive most or all medical services from a certain set (or network) of doctors and facilities. When you do so, such services are called in-network and are usually coverage better than for out-of-network services.
Services rendered by providers within a contracted Preferred Provider Organization Network for the group.