Contracted Provider


A medical provider that has an agreement with a health plan to accept their patients at a previously agreed upon rate for payment.


There are several benefits to being a contracted provider. First, the doctor is listed in the health plan's provider directory to attract new patients that have this insurance plan. Second, the physician knows in advance of the claim being paid what the reimbursement will be. Third, the patient benefits because the charge is usually discounted which lowers the patient's financial liability.

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