Under traditional health insurance plans, when you need the services of a doctor, you pay for the services and then make a claim against your policy for a portion, usually 80 percent, of the cost. Some doctors will set up a payment plan to help those who do not have all the money up front, but the client still pays the entire bill. This option poses problems for both doctor and patient. Bills do not always get paid on time, and occasionally, patients may be unable to afford necessary care. One of the biggest problems for patients is the huge differences in prices from one provider to the next. Many of today's health insurance plans, however, are handled differently. They are dominated by provider networks. Provider networks allow a group of doctors, hospitals and other medical services to work together and agree to a set cap on charges, as well as streamline care from one provider to the next.

The biggest advantage for you, the patient, is if you need to see five different doctors at five different facilities, all of your records and tests results will be in one place, interpreted by one doctor, your primary care physician. This solves many problems. In the past, some people who had several different doctors ended up with differing diagnoses due to no one doctor having the entire picture. That is changing, and the streamline care received through your insurance company's provider network can help you to live longer and in better health.

For doctors, the advantages are similar. Most doctors really do want to help their patients, and the ability to streamline care in this way allows them to do more. For doctors and providers, there are also other advantages. They have a larger pool of patients and a much better chance of being paid for their services, a win-win situation all the way around.

The disadvantages of provider networks in a health insurance setting are few for either provider or patient. For the patient, the only real disadvantage is inability at times to choose what doctor, specialist or facility that will provide care. This is not that difficult of a problem for most to overcome these days, however, because most provider networks offer thousands of choices in providers in every category.

For providers, the payoff for getting more patients is the need to agree to a cap on fees. Considering the difficulties in getting paid at all in the past, this trade-off seems to be working fine. Another issue that has to be dealt with is the rules imposed by the different provider networks. These rules can vary significantly from PPOs to HMOs.