A health plan network is a group of doctors, hospitals and other health care providers that has worked with us to get discounted rates for our members. When a health care provider is in a network, they're called preferred or in network.
When members use in-network providers, their health insurance covers more of the bill. If they choose a provider outside of the network (also called nonpreferred or non-network provider), their insurance pays less or sometimes nothing. So, it benefits members to use in-network providers.
Networks go beyond doctors and hospitals. We negotiate discounts on many kinds of health care services, including:
- Medical imaging such as MRI, CT and X-ray
- Laboratories that process bloodwork
- Medical equipment such as wheelchairs, oxygen, insulin pumps and wound care supplies
Prescription drugs and pharmacies
Here's why members should make sure that their medical care is in-network. A doctor might have a certain lab she uses or a medical imaging facility that she recommends. But the doctor may not know which facilities are in a member's network, so she might refer the member to one that's not in network, which could cost more money. Our goal is to help members save money and get the most out of their benefits, so making sure they ask the right questions is key.
If members are planning procedures such as surgery or MRI, they can learn more about their expected cost by signing in to asuris.com and using the Treatment Cost Estimator. They can also compare prices between providers and see which are in network.
If they're not sure what network they're in, they can call the number on the back of their member ID card and a Customer Service representative will be happy to help.
We want to help you help clients get the most value for their money. If you need help understanding networks, or helping your clients to find in-network providers or the best prices, just contact us. We're here to help.