Networks in health insurance plans refer to a list of providers (doctors, hospitals, labs, etc,) that have agreed to accept the terms of payment that apply to a particular health insurance plan. Health insurance carriers leverage their membership and use incentives to drive traffic to network participants.
In exchange, network providers accept the fee structure, agree not to balance bill more than the approved amount, and can expect prompt payment.
Networks come in different flavors. The more common ones are PPO (preferred provider organization), HMO (health maintenance organization and POS (point of service).
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In exchange, network providers accept the fee structure, agree not to balance bill more than the approved amount, and can expect prompt payment.
Networks come in different flavors. The more common ones are PPO (preferred provider organization), HMO (health maintenance organization and POS (point of service).