Insurance companies are fining hospitals for out-of-network care, arguing that federal changes are costing them more money. A new bill aims to stop those fines and protect consumers.

CareOregon, the largest Medicaid provider in the state, will soon stop covering mental health and substance use treatment from out-of-network providers. Coverage will will end on Oct. 1 for Medicaid ...

There was a time when a hospital contract renewal was one of the more boring events in healthcare. Health systems and payers would work through rate disputes in private, and patients rarely knew the ...

A network refers to a collection of health care professionals and facilities that contract with a health insurance company to provide care to the insurer’s plan members at discounted prices. It is ...

Executive SummaryThere is no more controversial issue in the outpatient market today than out-of-network billing. It is important to understand the risks as well as the benefits for your ambulatory ...

Recent moves in some states by insurers to restrict the use of out-of-network facilities by their members have created a headache for many ASCs around the country. Although out-of-network facilities ...

Patients are significantly more likely to go to an out-of-network provider when seeking behavioral care than when seeking medical or surgical care, according to a study conducted by Milliman and ...