Participating Provider


A physician or other medical provider has agreed to accept a set fee for services provided to members of a specific health plan. They are considered to be "in-network".


The importance of visiting a participating or non-participating provider is based on the payment rate. Health plans will provide incentives for their members to see a physician who is "participating" with their health plan. This is done because these participating providers have agreed to a reduced fee to provide services. Unlike non-participating providers who have not agreed to a specific rate, and could potentially be paid higher.

Want to learn more? Schedule a Consultation

Get started and schedule a no cost consultation with the Business Benefits Team to learn how your business can better manage your employee benefits.