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Preferred
Provider Organizations (PPOs)
| Preferred
Provider Organizations are another attempt to reduce medical costs.
This is an arrangement whereby a selected
group of independent hospitals
and medical practitioners in a certain area agree to provide certain
services at
a prearranged rate.
The
organizers and providers agree upon medical
service charges that are generally less than the provider would charge
patients
not associated with the PPO.
These
differ from HMOs in that the providers are paid on a fee for service
basis
rather than receiving a flat monthly amount and the organizer or
contracting
agency might be:
-
Traditional
insurance companies
-
Blue
Cross/Blue Shield
-
Local
groups of hospitals
-
Local
groups of physicians
-
An
existing HMO
-
Large
employers
-
Trade
unions
Those
people who will receive services select a preferred provider from a
list that
the PPO distributes.
Usually the choices are more extensive with a
PPO than a HMO.
Sometimes
PPOs and HMOs are lumped together and
called a managed care system.
One characteristic still exists concerning
regulation, however.
HMOs increasingly have to meet state
requirements as well as standard
established by federal government.
PPOs are less stringently regulated since any
group that can agree on the
arrangements can call itself a PPO.
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Introduction To Health
Insurance
Summary Of Health
Insurance Policies
Disability
Income Insurance
Standard Medical
Insurance
What Your Policy
Should Pay For
Additional Coverage
Some Policies May Include
Medical Conditions
Your Policy May NOT Cover
Comprehensive (Major)
Medical Insurance
Traditional
Health Insurance Providers
Domestic, Foreign
& Alien Health Insurance
Providers
Health Maintenance
Organizations (HMO's)
Preferred Provider
Organizations (PPO's)
Group Health Insurance
Finding The Best
Health Insurance Deal For You
Glossary Of Health
Insurance Terms
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