Yet another benefit is the elimination of seams such as silent PPOs
(in which providers submit out-of-network claims to an insurer only to get the claim repriced at a steep in-network discount), and cherry picking (which occurs when a provider belongs to more than one PPO
and a claim is shopped around for the lowest reimbursement rate accepted by a provider, regardless of the PPO
identified on the patient's ID card).
CDHPs, a nebulous euphemism for high-deductible PPO
health insurance plans with savings account components, are considered niche insurance products for the young and healthy who eschew physicians and hospitals.
Some policymakers favor PPOs
because they offer a model of managed care that is closer to traditional fee-for-service (FFS) than the health maintenance organization (HMO) options previously available to beneficiaries.
In both cases, much of the health-plan savings employers enjoy are based on hospital and physician discounts negotiated by a preferred provider organization (PPO
The market has delivered a clear-cut vote: Employers in most parts of the country love PPOs
When a contracting physician is unaware that a managed care organization (MCO) is selling or renting its preferred provider organization (PPO
) network to a third party, the third party is acting as a "silent PPO
." The third party could be a third-party administrator, insurance broker, or a smaller PPO
Since the Medicare Modernization Act contains few actual requirements for how the new PPOs
will be structured, it's unlikely that they will look like traditional Medicare, Mr.
You'll have to choose between a health maintenance organization (HMO), preferred provider organization (PPO
), or point-of-service plan (POS).
Despite the fact that PPOs
are the dominant form of insurance in the health care market, few studies have compared their costs and utilization to that of other forms of coverage.
(18) Nonetheless, court supporters eventually accepted the PPOs
as part of the system, albeit grudgingly.
Pepito Pico has batted for the creation of a passenger protection office (PPO
) in all major airports in the country.
While preparing its rates for 2019, CareFirst realized that thousands of its members in PPO
plans were paying more for the same services they could receive in the insurer's HMO plans.