Home > Terms > English, UK (UE) > Out-of-network provider

Out-of-network provider

A health care provider with whom a managed care organisation does not have a contract to provide health care services. Because the beneficiary must pay either all of the costs of care from an out-of-network provider or their cost-sharing requirements are greatly increased, depending on the particular plan a beneficiary is in, out-of-network providers are generally not financially accessible to Medicaid beneficiaries.

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  • Part of Speech: noun
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  • Blossary:
  • Industry/Domain: Health care
  • Category: General
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