Out of network (OON) - ProHealth Physicians
Introduction
Welcome to Greenstem Clinic, where we provide comprehensive healthcare services to our patients. In this section, we will discuss the concept of Out of Network (OON) services provided by ProHealth Physicians.
What is Out of Network (OON)?
Out of Network (OON) refers to medical services received from healthcare providers who are not contracted with your insurance plan. In other words, these services are performed by physicians or medical professionals who do not belong to the network of providers that your insurance company has established contracts with.
Why Choose Out of Network (OON) Services?
Although in-network providers offer certain advantages such as negotiated rates and lower out-of-pocket expenses, there may be situations where you might need to consider Out of Network (OON) services. Here are some reasons to choose Out of Network (OON) services:
- Specialized or Unique Treatments: In some cases, the healthcare services you require may not be available within your insurance provider's network. Out of Network (OON) services allow you to access specialized or unique treatments that might be necessary for your health.
- Access to Specific Providers: Out of Network (OON) services provide you the freedom to choose a specific healthcare provider, even if they are not part of your insurance network. This allows you to receive care from a trusted physician or specialist who meets your specific needs.
- Geographical Convenience: If you live in an area where there are limited in-network providers, Out of Network (OON) services can offer you more options for receiving quality medical care without being restricted to a specific network.
Understanding OON Billing
When you choose to receive Out of Network (OON) services, it is important to understand how billing works. Here are some key points to consider:
1. Higher Out-of-Pocket Costs
Out of Network (OON) services often come with higher out-of-pocket costs compared to in-network services. Insurance providers typically cover a smaller portion of the charges, leaving you responsible for a larger share of the expenses. Prior to receiving any Out of Network (OON) services, make sure to verify the expected costs and coverage with your insurance provider.
2. Submitting Claims
When you receive Out of Network (OON) services, you may need to submit claims directly to your insurance company for reimbursement. It is important to keep detailed records of the services received, including receipts and medical documentation. Your insurance provider will have specific instructions on how to submit claims and what information is required.
3. Coverage and Network Limitations
While Out of Network (OON) services offer flexibility, it is crucial to review your insurance policy to understand the coverage limitations. Some plans may have restrictions or higher deductibles for out-of-network services. Contacting your insurance provider directly can provide further clarification on coverage details.
Contact ProHealth Physicians for OON Services
If you are considering Out of Network (OON) services provided by ProHealth Physicians, our team at Greenstem Clinic is here to assist you. Our experienced and compassionate healthcare professionals are committed to providing you with the highest level of care.
Contact us today to learn more about the Out of Network (OON) services we offer, insurance coverage, billing information, and any other queries you may have. We are dedicated to supporting your healthcare needs and ensuring a positive patient experience.
