Out of Network Payments for ESRD Care Form

Instructions and help about Out of network Payments For ESRD Care

Hi and welcome to our series explaining the complexities behind provider terminations and what they mean for member healthcare. I'm joined today by Erica Stetson who will talk about what regular care needs look like when a provider leaves a network. Thank you for being here. Thank you Elaine, I'm happy to be here as a resource. So can you briefly explain the difference between in-network and out of network care? Sure. Members will pay more when they receive care from a provider who is not a part of their provider network. This is what we call out-of-network care and these providers are ones that Premera does not have a relationship with. Got it. So what does this mean for health plan members in the wake of a provider termination? All of the providers facilities would then be out-of-network? These facilities include urgent care locations, primary care clinics, specialty care facilities, medical centers, and all providers and healthcare professionals practicing at facilities run by this