What is a Network of Healthcare Providers?

Answer:
Many healthcare plans manage medical care and control

costs by using a system of health care providers within their service area. These providers can be physicians and medical facilities who agree to the terms of the medical plan. Each health care provider who joins the network agrees to certain rates and policies as set forth by the health organization.

As an insured with either an HMO or PPO that uses a network of health care providers, you agree to use the services of these network providers. If you see an out-of-network physician, you may have to pay the physician’s fee or pay a higher deductible or co-pay depending on the terms of your health plan.

When you have a health plan that uses a network of health care providers, you will receive a book listing all member physician’s and health care facilities so that you can choose one in your area who belongs to the network. You can also usually access a database of network members by going to your health plan’s website. By using a network physician or specialist, the paperwork is usually handled by the provider’s staff. All you need to do is show them your health insurance card.