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What’s a Provider Network, and Why Does it Matter?

Posted May 08, 2025 by Anupreet Kaur, M.D., Medical Director, Care Management and Population Health

You’ve probably heard about “in-network” vs. “out-of-network” providers, but what exactly do these terms mean and why do they matter? 

Consider this situation: You recently changed jobs and now have a new health insurance plan. However, after a recent visit to your primary care provider (PCP), you discover that your provider is now considered “out-of-network.” This means you’ll have to pay more out-of-pocket to continue...

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Choosing the Right Provider Network for Your Small Business

Posted October 15, 2024 by Steve Chrzanowski, Director, Group Retention & Sales Support

Selecting the right health insurance for your small business can seem overwhelming, but a crucial factor that should significantly impact your decision is the provider network included in the plan. A provider network is simply the group of doctors, advanced practice providers, hospitals, healthcare facilities and pharmacies your insurance company partners with to provide care for its members. These networks help lower healthcare costs by negotiating substantial discounts with...

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SummaCare Offers Healthcare Coverage and Access Throughout NE Ohio

Posted April 14, 2023 by Steve Chrzanowski, Director, Group Retention & Sales Support

When looking at healthcare plans for your small business, you need to look at more than just the bottom line. While costs are one of the biggest factors when choosing a healthcare insurance plan, allowing employees a choice of facilities and providers should also be a top priority because using in-network providers and facilities minimizes their out-of-pocket costs. Since your employees likely live in different communities, selecting a plan that offers access to care anywhere...

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What's the difference between exclusive and wide provider networks and is one better than the other?

Posted February 01, 2022 by Steve Chrzanowski, Director, Group Retention & Sales Support

Choosing group healthcare for your business is a big task. Not only do you want to offer employees affordable options, but you also want them to have convenient access to local providers. So, in addition to considering the monthly premiums, deductibles and co-pays associated with a plan, it’s important to look at the facilities, pharmacies, labs and providers that are part of a network.

To give consumers better value, many insurers offer plans that are less expensive...

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