Out of Network Specialist in Medical Billing
An out-of-network specialist is a healthcare provider who does not have a contract with the patient’s health insurance plan.
Out of Network Specialist in Medical Billing Explained
In medical billing, seeing an out-of-network specialist often results in higher out-of-pocket expenses for the patient because the insurance company does not have pre-negotiated rates with that specialist. The patient may need to pay the difference between the specialist’s charges and the insurance company’s reimbursement.
For example, if a patient visits an out-of-network cardiologist, they may be responsible for a higher portion of the bill than they would for an in-network provider.
Discover common acronyms and abbreviations in Medical billing glossary.
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