A safe and legitimate way to obtain out-of-network discounts is to negotiate each claim with the provider on a one-on-one basis.  This method averts nearly all of the wrap network issues, as the discount obtained is directly arrived at as a function of bargaining rather than access.  As a practical matter however, negotiation has its limits; the clear one being that it is labor intensive and not cost effective for low dollar claims (under $1,000 for physicians or $2,500 for hospitals).  Because low dollar claims comprise a large portion of out-of-network expenses (see the exhibit below) payers that employ this method exclusively could be leaving a lot of money on the table.