What does it mean if a provider is classified as a participating provider (PAR) in a managed care plan?

What does it mean if a provider is classified as a participating provider (PAR) in a managed care plan?

• A. They are out of network
• B. They are part of the network
• C. They only accept cash payments
• D. They provide emergency services only

Answer: (B)

When a provider is classified as a participating provider (PAR) in a managed care plan, it means that they are part of that network. This classification indicates that the provider has agreed to provide services to members of the health plan at pre-negotiated rates, which are typically lower than their standard fees. As a result, patients who see participating providers usually pay less out of pocket compared to those who go to non-participating providers. Participating providers are essential in managed care as they help control costs for both the insurer and the patient while ensuring that necessary services are available within the network.

When a provider is classified as a participating provider (PAR) in a managed care plan, it means that they are part of that network. This classification indicates that the provider has agreed to provide services to members of the health plan at pre-negotiated rates, which are typically lower than their standard fees. As a result, patients who see participating providers usually pay less out of pocket compared to those who go to non-participating providers. Participating providers are essential in managed care as they help control costs for both the insurer and the patient while ensuring that necessary services are available within the network.