What is an in-network provider?

An in-network provider is a health care provider or facility that has a contract with a health insurance company to provide health services at reduced costs to individuals with the insurance. In Arizona, in-network providers are allowed to charge insured individuals a predetermined rate for healthcare services. This rate is lower than what the provider would typically charge an uninsured individual, and the insurance company covers the remainder of the cost. In order to become an in-network provider, a provider must meet certain criteria that are established by the insurance company. This can include but is not limited to: having completed certain educational requirements, having proper licensure, having appropriate malpractice insurance, and agreeing to accept a certain payment rate from the insurance company. In-network providers benefit insured individuals by providing them access to medical care that costs less than what they would typically be charged. It also benefits the insurance company because it can reduce the amount of money paid out under the insurance plan.

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What is an in-network provider?

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