For a patient insured by an HMO, the phrase "out-of-network" means providers who are
A) only acting as a specialist.
B) not under contract with the payer.
C) licensed by the state.
D) whose offices are more than 50 miles from the patient.

Question

Quizplus · Accepted Answer

Out-of-network refers to healthcare providers who do not have a contract with the patient's health maintenance organization (HMO). This means the HMO does not cover or has limited coverage for services provided by these healthcare professionals, often resulting in higher out-of-pocket costs for the patient.

For a Patient Insured by an HMO, the Phrase "Out-Of-Network