In-network means that the provider has accepted a contractual agreement with the insurance company to follow their guidelines and accept the negotiated rates offered. Patients are encouraged to seek care from in-network providers to maximize their benefits and reduce out-of-pocket costs.
Out-of-network means the provider does not have a contractual agreement with the insurance company and is not required to accept that plan. There are no negotiated rates, and the patient will have a higher deductible and out-of-pocket cost including but not limited to possibly denied benefits. In these instances, the patient can opt for self-pay to help with the cost of their services.