• Mayer Insurance Agency

How Can I Verify if a Provider is in My Coverage Network?

Perhaps you recently or are about to change health insurance plans. If that is the case, you want to be sure that your top doctor or hospital is included in your policy. If you need to verify that a provider is in your coverage network, here is how to get started.

Going to a doctor within your insurance plan’s network helps to ensure you are getting the most out of your policy and minimizes your cost-sharing expenses. It is true that many individuals find themselves with unexpectedly large medical bills after seeing a doctor they believed were in the network, but were not.


Insurance providers build their plan offerings by inviting doctors to join their networks. When you visit a doctor who is in-network, you benefit from the negotiated payment rates the insurance plan and doctor have agreed upon. It is these rates that translate into lower expenses for you when you go in-network.


Knowing for certain which doctors are part of your network is not always simple or straightforward. However, you are right to be cautious and know before you book an appointment. Just because a provider accepts your insurance or is a part of some networks does not mean that he or she is included in your specific plan.


Typically, you can find this information online. However, do keep in mind that websites are not always updated frequently with the latest information. Networks change by the day. What’s more, sometimes the doctor’s medical group is listed as in-network, but not individual provider names. That means when you try to search for your specific provider, he or she might not show up even if they are in-network.


The most reliable way of finding out this information is to call your provider to verify who is included. It is also advisable to call your doctor’s office and ask for its tax identification number beforehand to streamline the process. That way, you can confirm if this medical provider is in your network.


Document your insurance customer representative’s name and identification number. Ask for verification of your in-network coverage to be sent to you in writing. This information could save you hassle if your doctor’s visit results in an unexpected bill.


If you find out that your physician is not within your provider network, it will be up to you to decide whether to stick with your doctor and have higher out-of-pocket costs or find an in-network provider.


Skip the search of finding the right health insurance provider for your needs. Visit Mayer Insurance in Apple Valley, Minnesota to secure your coverage today. We take the time to help you review your options, needs, and ensure you understand the contents of your coverage.

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