Why shouldn t I use “out of network providers”?
A. Managed care has greatly reduced the cost of medical procedures by setting limits on how much can be charged for each procedure. When you use a participating provider you are guaranteed the best possible prices for treatment and do not have to worry about balance billing. If you go to a non-participating provider several things happen; your deductible is usually increased, the co-insurance you pay is also greatly increased but more importantly, you are billed for total difference in what the insurance would have paid a participating provider. This amount does not stop when you hit the “out of pocket” limits. You should never use a non-network provider unless you have negotiated a fee schedule in advance and have it in writing. This can cost you a tremendous amount of money.
