Kelly AlhooiePelviBiz, Pelvibiz · Healthcare Business Strategy Assistant

If you're still relying on insurance to decide what you're worth, here’s a question for you:

15 Dec 2025 · 1 min

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0:56

A short conversational clip (YouTube) where one speaker explains to another that being "out of network" means insurance won't pay for patient visits. The exchange highlights how private practitioners bill insurers, the need to sign contracts with insurers to receive payment, and the implication that insurers effectively control how much practitioners are paid.

Chapters

Hey, man. How's it going? Well, I was supposed to do surgery today, but apparently I'm out of network, so the patient had to cancel. Out of network? What does that mean? It just means insurance won't pay for the patient to come see me for their health care. Oh. I didn't know you worked for the insurance company. What? I'm in private practice. I don't work for the insurance company. Are you sure? Of course I'm sure. So when you see a patient, you send a bill to the insurance company, right? Yeah. And then the insurance company will pay you for your services? Yeah, that's right. Well, who decides how much you get paid? Well. Well, you have to sign a contract with the insurance company. Well, what happens if you don't sign the contract? You don't get paid. Huh. So you do work, and the insurance company pays you for that work, and they pay you whatever amount they decide they want to pay you for the work you're doing. Yeah. I don't know. It kind of sounds like you're working for the insurance company.