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Health Insurance Glossary

Network Provider/Hospital

A network provider hospital is a hospital that has an agreement with a particular health insurance plan or network to provide medical services to its policyholder. Health insurance plans often have a network of healthcare providers, including hospitals, clinics, and doctors, that they contract with to provide medical services to their members.

If a hospital is a network provider, it means that it has agreed to the terms and conditions set forth by the health insurance plan, including reimbursement rates for medical services provided to plan members. This can be beneficial to both the hospital and the health insurance plan, as it allows the hospital to gain access to a larger patient base, while the health insurance plan can negotiate lower rates for medical services.

It is important for policy holders to check whether a hospital is a network provider for their health insurance plan before receiving medical services, as out-of-network providers are not covered and result in higher out-of-pocket costs for the patient.

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