out-of-plan services

out-of-plan services

services given to a patient by a provider outside the managed care system. The patient may be responsible for a larger copayment than if the services were received within the plan.
References in periodicals archive ?
The fact that agencies seeking out-of-plan reimbursement for services to Medicaid managed care enrollees typically billed the state rather than the plan may help explain why they experienced fewer reimbursement problems than did agencies billing private plans for out-of-plan services.
14%) about the out-of-plan services available from family planning clinics (not shown).
Eighty-eight percent of Planned Parenthood affiliates providing out-of-plan services cited confidentiality as a reason for women to seek contraceptive services from out-of-plan providers, more than any other type of agency.