out-of-network

out-of-network

adjective Referring to a provider/service that is not part of a managed care organisation’s network of contracted providers/services.

out-of-network

Managed care adjective Referring to a provider/service that is not part of an MCO's network of contracted providers/services. See Managed care organization.

out-of-network

Pert. to a health care provider or service that is not a part of an individual's health insurance plan. Most health insurers do not pay for services that are provided out of network. The recipient must pay for these services out of his or her own funds.
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Instead, the law came about because a California agency rejected an attempt by the insurance industry to impose wage and price controls on out-of-network physicians by regulation.
Out-of-network care can be problematic for health plans, safety-net hospitals, and health care systems and their members (Pham et al.
The consultants tried to get a rough estimate of the size of the behavioral health provider network adequacy problem by comparing how often patients in preferred provider organization (PPO) plans use out-of-network providers for behavioral health care, and how often the PPO plan patients use out-of-network providers for other types of care.
Patients who visit a hospital in their insurer's network may be surprised to receive a bill for services from an out-of-network provider who treated them during their stay.
network, some of the physicians who treated him were out-of-network,
In 2015, New York State enacted a law restricting the amount that out-of-network physicians could charge a patient.
State lawmakers want to see if they can do something about sky-high out-of-network air ambulance bills.
Santa Monica-based Consumer Watchdog said that the changes implemented by the insurance agency would no longer cover out-of-network doctors.
ATM fees set a new record high for the 10th year in a row, with the total cost of using an out-of-network ATM withdrawal rising to $4.
The new ownership will continue its focus to improve out-of-network claims savings solutions for third party administrators, employer groups, health plans, unions and brokers throughout the country.
Patients in specialist-deficient plans had high out-of-network costs, Mr.
The company's software uses a patented algorithm to identify substantial savings by analysing out-of-network "leakage," key clinical cost drivers and clinical variations.