In Network vs. Out-of-Network

We're often asked why we believe providers should opt to be In-Network with insurance companies. There are pros and cons to both sides, and today, we'll delve into a few of the more impactful ones.

For Out-of-Network, you're not contracted with an insurance company and therefore under no legal obligation to follow their payment guidelines. This means you can charge your standard hourly rate to the patient and not fall foul of Balance Billing. Now, Out-of-Network also means you'll have a smaller pool of prospective patients, as many plans don't cover out-of-network benefits. Even for plans with out-of-network benefits you'll likely to have to jump through hoops such as Authorizations, Gap Exceptions, and Referrals to consult.

There are three major reasons we think being In Network is important:

  • Once you're contracted with an insurance company, your name is posted in their directory and recommended to their patients. This means you'll have more exposure and reach a higher volume of clients. Additionally, patients are more likely to seek you out instead of you having to look for them.
  • Patients are more likely to book reoccurring visits with you if they don't have to pay for your services out-of-pocket. This is better for both the patient and for you.
  • Referring practitioners will seek out dietitians within their networks and recommend patients to them. 

Overall, we believe being In-Network to be a better experience for both you, the provider, and your patients.