We check on your insurance coverage and submit your benefits on your behalf as a courtesy. You are still responsible for understanding and knowing your benefits.
In-Network –
A provider has signed a contract agreement with the insurance company to provide their insured patients a “discounted” rate. The primary advantage of using an “in-network” provider is that you receive this negotiated or discounted rate for their services, and your insurance generally picks up a larger portion of the bill than with an out-of-network provider.
Out-of-Network –
A provider which has not contracted with your insurance company for reimbursement at a negotiated rate. Some plans, like HMO or DMO plans, do not reimburse out-of-network providers at all, which means that as the patient, you would be responsible for the full amount charged by your doctor. Other plans offer coverage for out-of-network providers, but your patient responsibility may be higher than it would be if you were seeing an in-network provider.
Please keep in mind that there are thousands of different insurance plans all with different stipulations for services.