What is a provider network?

A provider network is a group of medical providers that have contracted with a health insurance company to provide services to its members. In North Carolina, these providers must meet licensure requirements in order to be part of the network. A provider network includes both primary care providers (like family doctors and pediatricians) and specialists (like oncologists and cardiologists). The purpose of a provider network is to ensure that health insurance members have access to quality and affordable health care. The network allows members to select health care providers from a list of pre-screened and approved doctors and facilities, and receive covered health care services without having to pay out-of-pocket costs. When selecting a health insurance plan, it is important to make sure that the plan offers access to a provider network that includes the doctors and hospitals you would like to receive care from. It is also important to ensure that the care provided by the network’s providers meets the standards of quality and safety established by the state. By using a provider network, North Carolinians can make sure that they receive the highest quality care at an affordable cost.

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