Preferred Provider Organization

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Preferred Provider Organization

A health insurance plan in which the policyholder receives a discount from the full price if he/she receives medical services from a participating doctor, hospital, or other medical organization. In many ways, a PPO operates like other insurance policies: the policyholder pays a premium each month and, in exchange, the insurance company pays for the cost of medical care, after a deductible and co-insurance. What distinguishes a PPO from other policies is the fact that a group of doctors or hospitals may negotiate a discounted rate with the insurance company. This provides the policyholder with an incentive to receive care from this group. However, medicals services provided by organizations outside the group are also covered. See also: Health maintenance organization.

Preferred Provider Organization (PPO).

A preferred provider organization (PPO) is a network of doctors and other healthcare providers that offers discounted care to members of a sponsoring organization, usually an employer or union.

You may also arrange private insurance coverage through a PPO.

If you're insured through a PPO, you make a copayment for each visit to a healthcare provider, though certain diagnostic tests may not require copayment.

You typically have the option to go to a doctor or other provider outside the network, but you pay a larger percentage of the cost, called coinsurance, than if you used a network doctor.

References in periodicals archive ?
Higher (-dL*) values are realized when the middle blocks are PPO with terminal PEO units than when the reverse triblock architecture is the added component (Figs.
It's prudent to have your plan's medical expenses re-priced by each PPO network using actual--not assumed or averaged--discounts.
Encore Health Network, Indianapolis, is a PPO covering 211,000 Indiana members with health services through 10,000 physicians and 133 hospitals throughout the state.
Members have the option to enroll in the Aetna Advantage([TM]) Dental PPO Max Plan at the time of their medical election.
Encore Health Network (formerly VHA Health Plans), Indianapolis is a PPO covering 215,000 Indiana members with health services through close to 9,000 physicians and more than 100 hospitals throughout the state.
PPO Direct is offered as part of the membership benefit package for PPO network members of AHIP.
Indianapolis, is a dental HMO, PPO and indemnity company with more than 150 dentists serving 58,000 Hoosiers throughout Indiana's 92 counties.
Working with the state Insurance Department and Physicians Care PPO, the Blues stepped in to offer continuous coverage to the PPO's employer groups after its net worth fell below state requirements, forcing the PPO under the control of the Insurance Department.
Computer integration is a cornerstone of PPO manager George Fellows' push for "worldclass" quality and efficiency.
The PPO plans that have stepped forward to measure and report quality data are to be commended, and we look forward to the day when all Americans get the information about their care that they need to make smarter health care choices.
These three counties are contiguous to the current 18 county PPO service area.