In-Network versus Out-of-Network

This refers to the provider panels created by managed care companies. Managed care plans will contract with specific providers to provide services in an area, usually at a rate significantly lower than their usual fee. These providers will make-up the network for that plan. Any provider not in the network is considered out of network. Some providers remain out of network because the fees are too low, some because they feel the plan controls treatment and does not allow providers to provide high quality treatment, and some because they do not want to provide the insurance company with all of the confidential information about your treatment that is usually required by the managed care plans. Some providers are out of network because the network is closed, and will not accept new members.