In-network

What does In-network mean on a medical bill?

In-network means the provider signed a contract with your plan and agreed to accept the plan's rate as full payment for covered care. That contract is where the discount on your EOB comes from, and it is also what keeps the provider from billing you the leftover. Network status belongs to each provider and group, not to the building — an in-network hospital can be full of doctor groups that are not. It can also change between the day you booked and the day you were seen.

What does In-network usually cost?

The contracted rate is what the plan and provider settle on, and your share is figured from that number rather than from the charge. The same service can carry a different contracted rate at two in-network hospitals across the street from each other.

What should I watch out for with In-network?

• An in-network hospital where the doctor group inside it is not — check each provider separately
• Ask for the billing group's name or tax ID when you check the network, since it rarely matches the sign on the door
• Ask your plan to check network status on the date of service, not on the day you call