Out-of-network refers to medical providers, hospitals, and clinics that do not participate in a health insurer’s provider network because they have not signed a contract agreeing to the insurer’s negotiated prices.
Health plans may charge extra, impose a higher deductible, or increase the out-of-pocket limit for services provided by out-of-network professionals or facilities. Out-of-network providers may also bill patients for the remaining charges after the insurance company has paid its share.
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