Out of Network Provider

An out-of-network provider is one which has not contracted with
your insurance company for reimbursement at a negotiated rate.
Some health plans, like HMOs, do not reimburse out-of-network providers at all, which means that as the patient, you would be responsible for the full amount charged by your doctor. Other
health plans offer coverage for out-of-network providers, but your
patient responsibility would be higher than it would be if you
were seeing an in-network provider.