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Buzzword: Out-of-network

Marketplace Staff Feb 15, 2008
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Buzzword: Out-of-network

Marketplace Staff Feb 15, 2008
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Insurers on the outs bring us this week’s Marketplace Money buzzword: “Out-of-network.”

Most folks with health coverage know the drill: visit a doctor who isn’t contracted to your insurance company, you’ll pay extra.

But New York attorney general Andrew Cuomo says for the past decade, some insurers charged too much for out-of-network visits.

How? By purposely underestimating doctors’ “reasonable and customary charges” for those visits, leaving patients to pay more of the bill. Cuomo says it’s a “industry-wide scheme to deceive and defraud customers.”

His next step? To level reasonable and customary legal charges.

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