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Why should I use in-network providers?

Why should I use in-network providers?

Updated: January 28, 2024 · 5 Minute Read

Max Meyerhoff

Reviewed by:

Max Meyerhoff, Health Insurance Expert

Highlights

  • In-network providers are doctors and therapists that accept your health insurance as payment
  • Working with in-network providers can save you both time and money because they know how to work with your insurer

Choosing what providers to use for your child’s care, and figuring out how to pay for it, can be a major headache. One of our biggest tips for navigating these decisions is to use in-network providers. In-network providers are doctors and therapists that accept your health insurance as payment. 

 

Here’s why we recommend choosing in-network providers:

 

It’s a lower cost to you.

Your plan’s deductible (the amount you pay out-of-pocket before your plan starts to pay) and out-of-pocket maximum (the maximum amount you could pay out-of-pocket before your plan pays 100%) are lower when you receive services from in-network providers. This means less money out of your pocket.

 

It’s less work for you.

This is because…

In-network providers submit prior authorizations. Certain medical services require that you notify your insurance company before you can receive care (this is known as a prior authorization). Insurers often don’t pay for your care if you fail to submit an authorization for a service that requires one. When you go out-of-network, you are responsible for submitting prior authorization. In-network care providers do this on your behalf.

 

In-network providers submit claims. Submitting a medical claim can be a complex task as many components need to be listed to ensure the claim is approved. Providers have much more experience submitting claims than you do. This is a driving reason behind why in-network claim submissions for children with autism have a five times higher approval rate than out-of-network submissions (where you are responsible for submitting).

 

Using in-network providers saves you time and money, and it’ll decrease the risk of your child’s services being interrupted. That means more support with fewer headaches! If you want to make the most out of your child’s insurance plan, go with an in-network provider.