Tips on getting out of network care?

June 13, 2012 in Health Insurance, Medical Care


My family is luckily very healthy and we like our primary care doctors. I have not had any reason to see a doctor who is not on the list approved by my health plan. But now my daughter needs to see a counselor who is connected to a hospital where she make get treatment. The counselor is not in my insurers’ network, so I’m filling out the “Out of Network Request” form – any tips?

2 responses to Tips on getting out of network care?

  1. Be sure you know if your plan and or state prohibits what is known as “balance billing”. This can occur with out of network providers. In short, providers are reimbursed at a higher rate than in network providers. Some plan policies and or state laws forbid billing patients the remaining balance after an insurance payment.

  2. Thanks Sunni – I appreciate the tip!

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