Preferred Provider Organization. Doctor accepts a discount in his/her payments in return for being in a limited group of doctors. Supposed gets more patients in return for the smaller payments. Most prevalent insurance model.

Preferred Provider Organization. Contractual arrangements among hospitals, physicians, employers, insurance companies, or third-party administrators to provide health care services to subscribers at a negotiated, often discounted, price.

A type of managed care plan that should partially cover the care from out-of-network providers. To get full coverage, you must use network providers.

An organization offers healthcare services from a select group of "preferred providers" at reduced cost. Access to healthcare services from providers outside the PPO network is available, but the PPO customer must share more of the cost of such services.

A plan that usually combines features of indemnity and HMO coverage.  It generally offers traditional indemnity benefits plus some preventive and office visit coverage.  PPO's usually have some medical management guidelines, such as pre-authorization of hospital admissions and designated outpatient procedures. Members usually obtain services from contracted providers for lower cost sharing amounts and pay larger out-of-pocket amounts when receiving care from non-PPO providers.

In contrast to HMOs, PPOs health insurance plans permit you to use primary care providers outside the PPO network. You are given financial incentives to use doctors registered in the preferred group, however. These PPOs health insurance plans include small or no deductibles and lower coinsurance payments.

Prefered Provider Organization

Health care providers who are under contract to provide care at discounted or fixed fees. Unlike HMOs, health plans with a PPO allow you to choose any doctor at any time. However, if you select a non-PPO provider you will pay more out of pocket for services than you would if you selected a PPO "network" provider.

a plan that contracts with physicians at a discount for services. Providers exchanged discounts for increased volume and prompt payments. Participants’ out-of-pocket costs are usually lower than under an indemnity (fee-for-service plan.).

a health plan that uses a broader network than an HMO. Services obtained from participating providers are covered at a higher rate than services obtained from non-participating providers. A deductible applies to certain services.

See Preferred Provider Organizations.

A plan that contracts with independent providers at a discount for services. The physicians in a PPO are paid on a fee-for-service schedule that is discounted, usually about 10% to 20% below normal fees. The panel of providers is limited and usually has some type of utilization review system associated with it. PPOs are often formed as a competitive reaction to HMOs by physicians who contract out with insurance companies, employers, or third-party administrators. A patient can use a physician outside of the PPO providers, but he or she will have to bear a bigger portion of the fee.

An organization which contracts with providers of medical services (physicians and hospitals) to render services at discounted or pre-set fees to members of the PPO, in exchange for prompt payments and increased patient volume. The PPO then sells access to its network of providers to insurance companies and self-funded plans.

referred- rovider- rganization plan is a managed care plan which utilizes network providers to contain costs. Coverage is available out-of-network at higher out-of-pocket costs.

a health insurance plan that offers coverage by network doctors, hospitals, and other health care providers, but also provides a lower level of benefits for treatment by out-of-network providers. A PPO plan does not require the selection of a Primary Care Physician.

A PPO is an organization or group that has arrangements with doctors, hospitals and other healthcare providers that have agreed to accept lower fees from the insurer for their services. As a result, cost sharing is lower for plan members within a PPO network. Network healthcare providers make referrals, but plan members can self-refer to doctors and specialists, including those outside the plan. A PPO plan allows you to choose any doctor at any time. However, if you seek services from a non-network provider you will have more out-of-pocket expenses than if a PPO provider was utilized.

A PPO is an arrangement where providers (ie. Hospitals, physicians, surgery centers) contract with a health plan to provide services at a discounted rate to members, thus forming the PPO network. Members may use any provider in the PPO or outside the PPO, but have a financial incentive to use the preferred providers within the PPO.

Preferred Provider Organization. A group medical insurance plan in which members receive more coverage of services provided by participating hospitals and clinics and physicians.

Preferred Provider Organization. A health care plan that contracts with select providers who agree to offer health care services to enrollees at contractually set reimbursement levels. In return, these providers receive patients and prompt payment from the PPO. PPOs allow enrollees to receive health care services outside the PPO network, usually in exchange for a higher copayment or coinsurance amount. Enrollees receive benefit incentives if PPO providers are used.

Preferred Provider Organization. A network of providers which allows the enrollee the option of pursuing care outside of the network, for higher fees. All physicians are paid on a fee-for-service basis. Network physicians are paid reduced fees in exchange for their preferred status.

Preferred Provider Organization. ( Related information) A health plan in which consumers may use any health care provider on a fee-for-service basis. Consumers will be charged more for visiting providers outside of the PPO network than for visiting providers in the network (American Association of Preferred Provider Organizations).

Preferred Provider Organization. A CalPERS health plan with an established provider network that allows maximum benefit coverage when using its contracted physicians and hospitals. The plan may reduce benefits when you use providers outside of the set provider network.

Preferred Provider Organization. A health-care provider that contracts with an employer or an employer group to provide health-care services to employees at competitive rates.

Preferred Provider Organization. A managed care plan with a large network of physicians, hospitals and other providers.

Preferred Provider Organization. A PPO allows patients to see a doctor from the plan’s network of physicians for a small copayment fee. Patients who choose to see a doctor out of the network must pay the balance between the PPO’s scheduled fee and the billed amount.

Preferred provider organization. A form of managed care plan that allows patients to go outside of the plan and use non-participating providers, if they are willing to pay a greater share of the cost of service.

preferred provider organization - an insurance plan which allows choice of any provider in the network

A health care organization composed of physicians, hospitals, or other providers which offer health care services at a reduced fee. PPO's may also offer more flexibility by allowing for visits to out-of-network professionals at a greater expense to the policy holder. Visits within the network require only the payment of a small fee. A policy holder will have a primary physician within the network who will handle referrals to specialists that will be covered by the PPO. After any visit, the policy holder must submit a claim, and will be reimbursed for the visit minus his/her co-payment.

Preferred provider organization. A contractual arrangement in which providers negotiate with group purchasers, either directly or through the insurer or other third party, to provide health services for a given population.

Preferred Provider Organization. Subscriber may visit any dentist, or a discounted fee Preferred dentist (our offices are a PPO for most plans)

PREFERRED PROVIDER ORGANIZATION. A health care delivery system through which an organization of providers contracts to serve health plan enrollees on a fee-for-service basis at discounted fees in return for more patients. Patients may use any provider without a referral, in network or out, but have a financial incentive -- for example, lower coinsurance payments -- to use doctors on the preferred list.

Preferred Provider Organization. A network or panel of physicians and hospitals that agrees to discount its normal fees in exchange for a high volume of patients. The insured individual can choose from among the physicians on the panel.

Preferred Provider Organization. Hospital, physician, or other provider of health care which an insurer recommends to an insured. A PPO allows insurance companies to negotiate directly with hospitals and physicians for health services at a lower price than would be normally charged.

Preferred provider organization. A PPO is a managed care plan that contracts with providers to furnish services to plan enrollees. PPO providers are paid according to a discounted fee schedule. Enrollees may lower out-of-pocket costs when they use network ("preferred") providers. Services they receive from non-network providers, however, are also covered. Enrollees pay higher out-of-pocket costs when they use non-network providers for covered services.

"Preferred Provider Organization" is a health plan that contracts with providers of medical care at a discounted fee. Usually, the benefits and services delivered by participating providers cost members less than services from non-contracted providers.

Preferred Provider Organization. A type of health benefit plan designed to give enrollees incentives to use health care providers designated as “preferred providers”, but that also give substantial coverage for services received from other health care providers. PPO plans can also be distinguished from HMO plans by the ability of PPO members to see any specialty physician without referral from a PCP, although some HMOs with a POS feature may allow this as well.

Preferred Provider Organization. A network of physicians and facilities with which an organization has contracted to offer medical care at reduced rates.

Preferred provider organization. A health care plan offering either comprehensive or a limited range of health care services performed by providers selected by the plan. It allows members to use providers outside the network but enrollees may pay for a portion.

Preferred Provider Organization. A health benefits plan that lets members choose any provider without designating a primary care physician, but offers financial incentives to members who choose a "preferred" or in-network doctor or hospital.

Preferred provider organization. Health insurance with no primary care physician limitations. Instead, a list of preferred providers allows for fewer out-of-pocket expenses.

Preferred Provider Organizations. Type of health insurance program where a limited group of physicians and hospitals provide a broad range of medical care for a predetermined fee; individual who do not use the preferred providers for care usually have to pay a higher portion of their medical expenses.

Preferred provider organization. A selected group of hospitals and doctors and other medical providers who are contracted to perform services at a discount.

Preferred provider organization. A type of plan in which physicians, hospitals, and other providers agree to discount rates for an insurance company. These providers are part of the PPO´s network. Insurance contracts with PPO provisions reimburse at a higher percentage if you use providers in the network. If you go to providers outside the PPO´s network, you will have to pay more for your care.

You pay a monthly premium and can choose any physician (primary or specialist) without getting a referral first. When you use the doctors and hospitals that are part of the PPO, a larger part of your medical bills may be covered.

Preferred Provider Organization. A Preferred Provider Organization (PPO) plan is similar to a Point-of-Service (POS) plan in offering coverage by a network of providers, as well as coverage for out-of-network services. In a PPO plan, you can go to a network specialist for the co-pay of $5, $10 or $15, without obtaining a referral from a Primary Care Physician (PCP). You are not required to choose a PCP in a PPO plan. Pre-certification requirements will still be maintained.

preferred provider organization. a group of health care providers who band together to provide health services for set fees

Preferred provider organization. PPOs give policyholders a financial incentive  reasonable co-payments(also called co-pays)  to stay within the group's network of practitioners. You may go to any specialist without permission, as long as the doctor participates in the network. If you see an out-of-network doctor, you may have to pay the entire bill yourself, then submit it for reimbursement. You may have to pay a deductible if you choose to go outside the network, or pay the difference between what network doctors vs. out-of-network doctors charge

preferred provider organization. Plan through which a sponsoring group negotiates price discounts with providers in exchange for patients. The sponsor may be an insurer, employer, or third-party administrator

PREFERRED PROVIDER ORGANIZATION. An organization which, among other things, contracts with health plans to provide a network panel of physicians.

Preferred Provider Organization. A health plan that requires deductible and coinsurance for services rendered. You may choose either in-network or out-of-network providers. When you use the doctors and hospitals that are part of the PPO, you can have a larger part of your medical bills covered. You can use other doctors, but at a higher cost.

Preferred Provider Organizations typically consist of a network of providers that have agreed to provide services to plan members at discounted rates. These are generally considered the most flexible managed care plans because they usually don't require members to choose a Primary Care Physician (PCP). This means your employees receive the same coverage for any provider within the network, including specialists. They can also choose a provider outside of the network and receive coverage, though the out-out-pocket expenses will likely be higher.

Preferred Provider Organization. An arrangement whereby a third-party payer contracts with a group of medical care providers who furnish services at lower than usual fees in return for prompt payment and a certain volume of patients.

Preferred Provider Organization. A preferred group of dentists who have contracted to provide dental services at a discounted rate in return for access to the insurance plan's subscribers. Can be known as contract dental organization (CDO).

Preferred Provider Organization. A formally organized entity of hospital and outpatient providers that agrees to accept discounted fees for treating enrollees of a managed care plan in return for prompt payment and an expectation of a larger volume of patients. Enrollees may choose non-PPO providers but usually pay a higher portion of the costs than for PPO providers.

Preferred provider organization; a type of managed health care plan.

Preferred Provider Organization. Most Carriers have entered into agreements with organizations of doctors and other health care professionals called PPOs in order to establish fees and rates that are lower than average for their health insurance policy holders. Under a PPO health insurance policy, the health insurance policy holder will be charged a lower rate for treatment from a member of the PPO. However, any health care received from a provider outside of the designated PPO will either not be covered or will be covered at a lower rate from the carrier making the cost for that treatment or service to the health insurance policy holder greater.

Preferred Provider Organization” is a type of group health plan. The medical professionals in the system agree to accept a standard fee schedule and patient care controls; the system is usually organized by an insurance company. In a PPO, the policyholder can go to any medical provider in the PPO network and pay the co-payment amount for each regular service. If the policyholder chooses to go to an out-of-network provider, he/she often pays that doctor’s fees directly and files for reimbursement from the insurance company. This is a greater cost. For that reason, the PPO system encourages its policyholders to see the doctors and health providers who are part of the system.

Preferred Provider Organization. A network of doctors, hospitals and other healthcare providers who provide healthcare services to plan members. Members have the flexibility to choose a network provider or to select any provider outside the network, each time they need healthcare. Members save money when they use in-network providers.

Preferred Provider Organization. Payer directly contracts with individual providers at reduced fees, usually fee-for-service, with a commitment to guaranteed volume. Enrollees have incentives to utilize these providers.

Preferred Provider Organization. A managed care plan in which you use doctors, hospitals, and providers that belong to the network. You can use doctors, hospitals, and providers outside of the network for an additional cost.

Preferred provider organization. An arrangement whereby a payer contracts with a group of health care providers (for example, doctors, nurses, lab people) to provide services at lower than usual cost. In return, the insurance company promises to pay these people quickly and make sure they get a certain number of patients.

arrangements in which physicians, hospitals and other healthcare providers contract to provide health care on a negotiated fee-for-service basis to predetermined groups of beneficiaries. Enrollee choices are limited to a list of "preferred" providers. The PPO offers the consumers more freedom of choice of provider than do HMOs. In a PPO, the insured is presented with the financial incentive to use a participating provider. Doctors have their own practice but agree to accept fees set by the group. See Hospital/Physician Integration.

Preferred Provider Organization. Under the FEHB Program, PPOs are only available through enrollment in a Fee-For-Service plan. The PPO is similar to FFS insurance except it uses a network of providers. PPO's give you the choice of using doctors and other providers within the plan's network (the PPO benefit), or using ones outside the plan's network. You don't have to use the PPO, but there are advantages if you do. (Be aware, however, that some of the services provided in a PPO hospital may not be covered by PPO arrangements. Room and board will be covered, but anesthesia and radiology, for instance, will probably be covered under non-PPO benefits.)

Preferred Provider Organization. This a health option provided to retirees who move out of the service area. It provides discounted services in a designated area.

A health care network of primary care doctors, specialists, hospitals and other providers of care, the preferred provider organization focuses on delivering cost-effective, quality patient care. Members save money when they use network providers and avoid a sanction for out-of-network services.

Preferred Provider Organization. A fee-for-service option where you can choose plan-selected providers who have agreements with the plan. When you use a PPO provider, you pay less money out-of-pocket for medical services than when you use a non-PPO provider.

Preferred provider organization. a network of medical care providers who have agreed to provide services at negotiated rates and have a contract with the plan.

Preferred Provider Organization. Network of health care providers having negotiated contracts with a health insurance company for its members to receive services at lower costs. Patients generally maintain the freedom to choose within the network in a PPO arrangement.

Preferred Provider Organization. An arrangement in which you or your employer receive discounted rates if you use doctors or hospitals from a pre-selected group, (the PPO).

Preferred Provider Organization. A type of insurance plan.

Preferred Provider Organization. A PPO incorporates a network of participating health care providers. However, there is no primary care physician (PCP) to coordinate care, and patients may seek care from any provider in the network without a referral. Network providers accept pre-negotiated fees from insurance carriers as payment for various services, with the patient responsible for either a co-payment, or deductible and coinsurance, depending upon the plan design. If the patient chooses a non-network provider, he or she will assume a larger portion of the cost.

Preferred Provider Organization. a health care delivery arrangement which offers insureds access to participating providers at reduced costs. PPOs provide insureds incentives, such as lower deductibles and copayments, to use providers in the network. Network providers agree to negotiated fees in exchange for their preferred provider status.

An organization where providers are under contract to an insurance company or health plan to provide care at a discounted or negotiated rate. Typically, you can see any doctor in the PPO network without requiring special approval, and you usually do not need to choose a primary care physician. Most PPOs will also allow you to seek care outside of the PPO network; however, the benefits are usually reduced and the insured has a greater out-of-pocket expense.

Preferred Provider Organization. Some combination of hospitals and physicians that agrees to render particular services to a group of people, perhaps under contract with a private insurer. The services may be furnished at discounted rates and the insured population may incur out-of-pocket expenses for covered services received outside the PPO if the outside charge exceeds the PPO payment rate.

Preferred provider organization. A health care benefit plan where medical providers agree to offer their services at a discount. In return, the plan offers members incentives to choose these in-network providers. Coverage for services from other health care providers is available, but at a higher out-of-pocket cost to the member.

Preferred Provider Organization. A health care delivery system that contracts with providers of medical care to provide services at discounted fees to members. Members may seek care form non-participating providers but generally are financially penalized for doing so by the loss of the discount and subjection to copayments and deductibles.

preferred provider organization. A healthcare provider group that offers reduced medical costs to members.

Preferred Provider Organization- PPOs are a type of managed care organization, but they normally do not require a PCP. They are generally a network of providers that one can see for their standard co-pay. In a PPO, a patient can opt to go out of network, but will have to pay for any difference in cost between what a PPO normally reimburses and the doctor charges.

preferred provider organization. A group of hospitals and physicians that makes a contract with employers, insurers, and other organizations to provide comprehensive health care services at discounted fees for individuals who are members of the PPO.

Preferred Provider Organization. A type of HMO that has contracts with a network of doctors to provide services to plan members. Typically, PPOs also extend full or partial coverage to non-contracted providers under certain circumstances. PPO doctors are often paid on a capitation basis.

Preferred Provider Organization. a managed care organization that contracts with select providers of medical care thereafter referring to as preferred providers. Covered individuals are encouraged or required to utilize the preferred providers in order to gain better benefits, higher levels of coverage or any coverage at all. PPO's seek to managed care to assure the most efficient outcomes. Providers may be, but are not necessarily, paid on a discount fee-for-service basis.

Preferred provider organization. group of health care providers who enter into a contract with Northrop Grummanâ€(tm)s medical PPO plans to provide services to participants at a specified, discounted fee. Similar to a network.

Preferred provider organization. Individuals covered by this type of managed care plan may see doctors outside the network without a referral, but at an additional cost.

A network of health care providers that have agreed to provide medical services to a health plan's members at discounted costs. PPO members typically make their own decisions about their health care rather than going through a primary care physician like HMO member. The cost to use physicians within the PPO network is less than using a non-network provider.

Preferred provider organization. A managed care plan that contracts with a select group of participating providers. PPO coverage typically allows members to use non-PPO providers, but higher levels of coinsurance or deductibles may apply to services provided by non-participating providers.

Preferred Provider Organisation

Preferred Provider Organization. A combination of traditional fee-for service and HMO health plans. This is an organization of providers who have agreed to provide medical services for a discounted rate. You can see any doctor in the PPO network without requiring any special approval, and you usually do not need to choose a primary care physician. You may also seek care outside the PPO network, but you will be incurring higher out-of-pocket expenses.

Preferred Provider Organization. Having a PPO means that you can see the provider of your choice. Providers may be "in-network" with the PPO or "out-of-network". Providers who join a network offer their services to the members at a discounted rate. If your provider is not contracted with the plan, your PPO may still provide coverage, but often at a reduced benefit rate.

Preferred Provider Organization. FFS Plans and many HDHPs use PPOs which are a network of providers. PPOs give you the choice of using doctors and other providers in the network or using non-network providers. You don’t have to use the PPO, but there are advantages if you do. (Be aware, however, that some of the services provided in a PPO hospital may not be covered by PPO arrangements. Room and board will be covered, but anesthesia and radiology, for instance, may be covered under non-PPO benefits.) Note that some FFS plans may offer an enrollment option that is "PPO­-only." You must use network providers to receive benefits from a PPO­-only plan.

Preferred Provider Organization. There are various types of PPOs. Generally, you choose your care providers from listings of independent care providers with whom the health plan has negotiated rates.

Preferred Provider Organization. A Preferred Provider Organization is a network of health care providers who provide services to patients at discounted rates or cost shares.

Preferred Provider Organization. Health care plan where members may choose to receive care from any provider but are encouraged to use the preferred network of contracted providers by offering lower copays.

The abbreviation for preferred provider organization. A fee-for-service program that allows you to choose any dentist but provides financial incentives to choose dentists who are part of the PPO network. DeltaPreferred Option is a PPO program.

Preferred Provider Organization. A healthcare benefit arrangement designed to supply services at a lower cost to use in-network healthcare providers (who contract with the PPO at a discount). The PPO also provides coverage for services rendered by healthcare providers who are not part of the PPO network at a higher out-of-pocket cost to the member.

PREFERRED PROVIDER ORGANIZATION. A type of managed care in which the providers provide services at pre-arranged prices on a fee-for-service basis rather than on a pre-paid basis. If the insured uses one of these, they usually have no or low deductible or copayment.

Preferred provider organization. Term applied to a variety of direct contractual relationships between hospitals, physicians, insurers, employers, or third-party administrators in which providers negotiate with group purchasers to provide health services for a defined population, and which typically share the following three characteristics: (1) a negotiated system of payment for services that may include discounts form usual charges or ceilings imposed on a charge, per diem, or per discharge basis, (2) financial incentives for individual subscribers (insurers) to use contracting providers usually in the form of reduced co-payments and deductibles, broader coverage of services, or simplified claims processing, and (3) an extensive utilization review program.

Preferred Provider Organization. Group of hospitals and/or physicians that contract on a fee-for-service basis with employers, insurance plans or third-party administrators to provide health care.

Preferred Provider Organization. a health plan in which a member's health care services are completely paid for if obtained from one of a select group of 'preferred' providers chosen by the plan, or partially paid if obtained from an unaffiliated provider.

preferred provider organization. A managed health care plan that arranges with health care providers for the delivery of health care at a discounted cost and provides incentives for PPO members to use the health care providers who have contracted with the PPO, but that also provides some coverage for services rendered by health care providers who are not part of the PPO network. See also managed health care plans and preferred provider arrangement (PPA).

Preferred provider organization. A managed care organization that allows members to seek care from in-network physicians without having to designate a primary care physician. As a result, members are not required to obtain a referral before visiting another physician or specialist within the network. Members are allowed to see physicians who are not part of the network but at greater cost.

Preferred Provider Organization. a managed care arrangement that offers enrollees a large choice of primary care and specialty providers from which to choose with fewer utilization restrictions than offered by an HMO. This differs slightly from the typical HMO, in that visits to specialists usually do not require authorization by a Primary Care Physician (PCP). Also, unlike most HMOs, out-of-network usage is allowed by PPOs, though at a higher cost to the member.

Preferred Provider Organization. A health care delivery system that contracts with providers and health care organizations to provide services at discounted fees to members

A preferred provider organization (PPO) is an insurance plan that encourages enrollees to get care from providers within the plan's network, but allows access to providers outside the network if one is willing to pay more. Many PPOs do not require the insured person to choose a primary care doctor or get a referral to see a specialist.

Preferred Provider Organization. A company that hascontracts with physicians, hospitals, and other providing organizationsto deliver care at specific costs, usually discounted. Legalized in moststates now after pressure by insurance companies and industry in anattempt to lower health care costs.

Type of health insurance in which patients may choose from a physician from a list of providers who have agreed to offer care at a discount.

Preferred Provider Organization. A network of doctors and hospitals that provides care at a lower cost than through traditional insurance. PPO members get better benefits (more coverage) when they use the PPO's network of health care providers. They pay higher out-of-pocket costs when they choose to get care outside the PPO network.

The abbreviation for a preferred provider organization, a kind of health insurance plan. People who join PPO plans agree to pay a higher percentage of their medical expenses when they use medical providers who are not a part of the PPO.

(Preferred Provider Organization) Health plan with option to use providers in a network or out of a network. Benefits are richer with network providers.

Preferred Provider Organization. An organization of hospitals and physicans who provide, for a set fee, services to insurance company clients. These providers are listed as preferred and the insured may select from any number of hospitals and physicians without being limited as with an HMO. Coverage is 100%, with a minimal copayment for each office visit or hospital stay. Contrast with Health Maintenance Organization.

Preferred Provider Organization. A group of health care providers that contracts with employers, insurance companies, union trust funds, third-party administrators, or others to provide medical care services at a reduced fee. PPOs can be organized by the providers themselves or by organizations such as insurance companies, the Blues, or groups of employers.

Preferred Provider Organization. A type of Health Benefit Plan designed to give Members incentives to use health care providers designated as Network Providers, but that also provide reduced Benefits for Covered Services received from Non-Network Providers. PPO plans can also be distinguished from HMO plans by the ability of PPO members to see any specialty physician without referral from a PCP.

Preferred Provider Organization. A group of providers who contract on a fee-for-service basis with employers, insurance plans or other plan administrators to provide medical services.

PREFERRED PROVIDER ORGANIZATION. HMOs offer patients incentives like lower costs for certain doctors. But patients are allowed to seek outside doctors.

Preferred Provider Organization. A group of hospitals and physicians that contract on a fee-for-service basis with employers, insurance companies or other third party administrators to provide comprehensive medical service. Providers' exchange discounted services for increased volume.

Preferred Provider Organization. a contractual arrangement between independent providers and an employer or insurance company to deliver health services to a defined population at established fees. The PPO contains a panel of physicians and health care institutions that are the preferred providers. Health care services are delivered on a fee-for-service basis at established rates, usually discounted from the physician's usual and customary rates. PPO members pay a larger coinsurance amount for using non-preferred providers.

Preferred Provider Organization. A health care delivery system in which an insurer or employer negotiates price discounts with certain providers.

preferred provider organization. A health care delivery system in which the employer or insurer enters into contracts with health care providers (physicians, hospitals, etc.), to provide health care services at a discount.

Preferred Provider Organization. A type of Health Benefit Plan designed to give Members incentives to use health care providers designated as "preferred providers," but that also give substantial coverage for services received from other health care providers. A PPO that requires the use of a PCP is sometimes referred to as a "Point of Service" (POS) plan.

Preferred Provider Organization. A special type of managed care plan under which you don't usually need permission from your Primary Care Physician to see a specialist.

Preferred Provider Organization-a health care arrangement which offers insured's access to participating providers at reduced costs. PPOs provide insured's lower deductibles and co-payments, to use providers in the network. Network providers agree to negotiated fees in exchange for their preferred provider status.

(Preferred Provider Organization): A select, approved panel of physicians, hospitals and other providers who agree to accept a discounted fee schedule for patients and to follow utilization review and preauthorization protocols for certain treatments.

PREFERRED PROVIDER ORGANIZATION. A network of doctors, hospitals and pharmacies which provide services based on a discounted predetermined fee. Care can be provided by either a network or non-network provider. Unlike an HMO, PPO's do not require the selection of a Primary Care Physician.

Health care providers who are under contract to provide care at discounted or fixed fees. Unlike HMOs, health plans with a PPO allow the insured to choose any doctor at any time. However, if the insured selects a non-PPO provider he will pay more out of pocket for services than he would if he selected a PPO "network" provider.

Preferred Provider Organization. An arrangement whereby an insurer or managing entity contracts with a group of health care providers who furnish services at lower than usual fees in return for prompt payment and a certain volume of patients.

A combination of traditional fee-for-service and an HMO. When you use the doctors and hospitals that are part of the PPO, you can have a larger part of your medical bills covered. You can use other doctors, but at a higher cost.

Preferred Provider Organization. A combination of traditional fee-for-service and HMO health plans. There is a network of providers that have agreed to provide services for a discounted rate. When you use the doctors and hospitals that are part of the established PPO network, a large part of your medical bills are covered. You can use other doctors outside the network, but at a higher cost.

Preferred provider organization. A type of managed care plan where members obtain services from a network of physicians who have nonexclusive arrangements with the managed care plan. Members also receive some benefit coverage when they obtain services from providers who are not in the plan's network.

Preferred provider organization. A type of health care plan that gives patients a choice of using doctors and hospitals in a network and paying a copayment or using physicians and hospitals outside the network and being responsible for a paying an annual deductible and a percent of the bill for the visit.

Preferred Provider Organization. PPOs generally provide "in-network" and "out-of-network" benefits and do not require a Primary Care Physician referral to see a specialist. The amount the member must pay out of pocket is less when using an "in-network" provider.

Health plan that allows you to receive care from any licensed provider with are financial incentives-such as higher levels of reimbursement-to use the preferred network of contracted providers.

Health plans which are similar to traditional fee-for-service health insurance. You choose a doctor, but pay less out of your own pocket if you select a doctor who is in the network. Patients are reimbursed 80 percent to 100 percent for treatment within the PPO versus 50 percent to 70 percent outside it. PPOs usually have fewer administrative rules than HMOs. For example, they usually do not use primary-care physicians to coordinate patient care.

PREFERRED PROVIDER ORGANIZATION. An organization of providers who have agreed to provide designated services and accept assignment of benefits for those services.

Preferred Provider Organization. nbspWhen you use the doctors and hospitals that are part of the PPO Network, you can have a larger part of your medical bills covered. You can us other doctors, but at a higher cost to you. You do not need a referral from a Primary Care Physician.

Preferred Provider Organization. A group of providers that have banded together in hopes of preserving and enlarging their market share by providing discounted services to groups with which they have contracts. These organizations can be of two types: (a) one is risk-bearing and provides its services in exchange for a pre-set monthly payment; (b) the other is non-risk-bearing and provides discounts off its usual charges.

Preferred Provider Organization. Another type of managed care plan. Members have a choice of utilizing healthcare providers in the PPO network, or hospitals, doctors and other healthcare professionals outside the plan for an additional cost. Beginning in 2003, PPO plans are available to Medicare beneficiaries in 23 states.

Preferred Provider Organization. Managed care arrangement consisting of a group of hospitals, physicians and other providers who have contracts with an insurer, employer, third-party administrator or other sponsoring group to provide health care services to covered persons.

Preferred Provider Organization. A type of managed care plan which contracts with independent providers for negotiated discounted fees for services provided to covered persons.

Preferred Provider Organization. A healthcare organization comprised of physicians, hospitals, and ancillary service providers that offers medical services at a reduced fee. PPO members pay for care on an as-needed basis. PPOs allow members to receive out-of-network medical services, but at a reduced rate of reimbursement. Typically, the member pays a deductible and higher co-payment when receiving out-of-network care.

A network of health care providers that offers medical services to health plan members at a discounted cost. PPO members usually make their own decisions about their health care instead of going through a primary care physician like an HMO member. The costs to use physicians within the PPO network are less than using a non-network provider.

Preferred Provider Organization. A type of health plan which encourages a member to use in-network providers, but that also provides reduced benefits for covered services if the member chooses an out-of-network provider for care. See health plan product descriptions.

Preferred Provider Organization. A managed care program that combines the freedom of fee-for-service with cost-management features by encouraging patients to use participating dentists. These dentists are selected either for their moderate fees or because they have agreed to accept a reduced fee schedule for PPO patients. Patients may choose any dentist, but will receive the highest level of benefits by selecting a PPO dentist. [Delta Dental's PPO program is known as DELTA PREFERRED OPTION.

Preferred Provider Organization. A type of managed care coverage based on a network of doctors and hospitals that provides care to an enrolled population at a prearranged discounted rate. PPO members usually pay more when they receive care outside the PPO network.

See preferred provider organization.

preferred provider organization. A health care benefit arrangement designed to supply services at a discounted cost by providing incentives for members to use designated health care providers (who contract with the PPO at a discount), but which also provides coverage for services rendered by health care providers who are not part of the PPO network.

Preferred Provider Organiztion. Similar to HMOs, but physicians are paid on a fee for services basis, and insureds are not required to use member physicians (but there are financial incentives in doing so.)

Preferred Provider Organization. A group of health care providers (physicians, hospitals, and other providers) located within a specific geographical area that have contracted with an entity (a physicians' group or hospital, for example) to provide health care services.

Physician Practice Organization

Preferred Provider Organization. A managed care plan that provides health care to its members on a prepaid basis. In a PPO, you can get care from the doctors and hospitals in the plan's network or pay more to go to doctors and hospitals outside the network. Many PPOs don't require you to choose a primary care doctor or get a referral to see a specialist.

or Preferred Provider Organization A medical insurance provider under which services are obtained via a network of preferred doctors and facilities. Usually, you receive lower benefits if you obtain services from non-preferred doctors or facilities. See a comparison between HMOs and PPOs.

Preferred Provider Organization. A network of individual healthcare providers brought together under one insurance plan. A consumer will be required to select only from this list to be covered under the insurance plan.

Preferred Provider Organization. A sponsor that negotiates price discounts with medical providers in exchange for more patients. The sponsor may be an insurance company, employer or third-party administrator.

Preferred Provider Organization. In 1991, Colorado enacted a statute that allows insurance companies to offer a "PPO" option. That means for a reduced rate, the consumer agrees to use a specific PPO for medical treatment for injuries suffered in auto accidents. This is an option only. Consumers can save up to 25-percent on the medical portion of their auto insurance premium.

Preferred Provider Organization. Ohio Med. A network of hospitals and doctors who have agreed to serve Ohio Med PPO members at a discount. If you use a hospital or provider in the PPO network, you are covered at a higher percent than if you go to a provider outside the network. Employees can use providers who are not part of the PPO but will pay a higher copayment. PPO providers will file claims for you and accept Ohio Med’s allowed amount as payment in full for most covered services. For some benefits and services, you are required to pay deductibles and copayments.

Preferred Provider Organization. A network of doctors and hospitals that contract with an insurance company or employer to provide employees with services at competitive rates.

Preferred Provider Organization. A network of health care provider that have agreed to provide medical services to members of a health plan at discounted costs. PPO members typically have greater flexibility in selecting healthcare providers.

Preferred Provider Organization: The health insurer contracts with a network of medical providers who agree to accept lower fees and/or to control utilization. The enrollee receives a higher lever of benefits if they go to a preferred provider than if they go to a non-preferred provider.

Preferred Provider Organization. A PPO is a form of managed care closest to an indemnity plan. A PPO has arrangements with doctors, hospitals, and other providers of care who have agreed to accept lower fees from the insurer for their services. As a result, your cost sharing should be lower than if you go outside the network. In addition to the PPO doctors making referrals, plan members can refer themselves to other doctors, including ones outside the plan. If you go to a doctor within the PPO network, you will pay a co-payment (a set amount you pay for certain services—say $20 for a doctor or $15 for a prescription). Your co-insurance will be based on lower charges for PPO members. If you choose to go outside the network, you will have to meet the deductible and pay co-insurance based on higher charges. In addition, you may have to pay the difference between what the provider charges and what the plan will pay.

A plan that offers discounted rates on services to members who use providers in the network. Often, if the individual seeks care outside the network, a smaller portion of the charges is reimbursed.

Preferred Provider Organization. A managed care plan that contracts with networks or panels of providers, which furnish services and are paid according to a negotiated fee schedule. Enrollees are offered a financial incentive to use providers on the preferred list, but may use non-network providers as well.

Preferred provider organization. Individuals or employers receive discount rates if they use health care services from a selected group of providers.

preferred provider organization. Health] a group of health care providers (which may include physicians and hospitals) that contracts with a plan administrator or sponsor to provide certain health care services, usually at a discounted rate (identical to ASOP No. 16]; distinguished from EXCLUSIVE PROVIDER ORGANIZATION, HEALTH MAINTENANCE ORGANIZATION

Preferred Provider Organization. A type of health benefit program in which enrollees receive the highest level of benefits when they obtain services from a physician, hospital, or to her health provider designated by their program as a "preferred provider". Enrollees may receive substantial, though reduced, benefits when they obtain care from a provider of their own choosing who is not designated as a "preferred provider" by their program.

PREFERRED PROVIDER ORGANIZATION. Network of medical providers which charge on a fee-for-service basis, but are paid on a negotiated, discounted fee schedule.

Group (network) of preferred providers (Hospitals, Doctors, Lab, etc.) that have agreed to provide their services to member groups of the PPO for a discounted fee. The reason they accept a lesser fee is the principle that through plan design incentives implemented by the group these providers will have the opportunity to receive more patients and generate a profit by increasing their volume of patient encounters.

Preferred Provider Organization. A network of health care providers with which a health insurer has negotiated contracts for its insured population to receive health services at discounted costs. Health care decisions generally remain with the patient as he or she selects providers and determines his or her own need for services. Patients have financial incentives to select providers within the PPO network.

Preferred Provider Organization (Associated with Traditional)

Preferred Provider Organization. Managed care entity that consists of hospitals, physicians, and other providers on contract to an insurer, employer, third-party administrator, or other sponsoring group to provide health care services to covered individuals.

PREFERRED PROVIDER ORGANIZATION. An insurance benefit in which member hospitals and/or physicians contract with a third-party payer to deliver services for negotiated fees, usually at a reduced rate. Incentives are provided to use contracted providers.

Preferred provider organization. An organization of participating providers that have agreed to provide their services at negotiated discount fees in exchange for prompt payment and increased patient volume.

Preferred Provider Organization. The UT Select PPO plan is administered by Blue Cross Blue Shield of Texas. Members have the option to use network or non-network providers. To receive network benefits, members must utilize Blue Cross Blue Shield PPO providers. An office visit is a $25 co-payment with a family care physician and a $30 co-payment with a specialist. For other covered services, there is a $250 deductible before the plan pays 80% of all services considered reasonable and customary and the member pays 20%. The maximum amount payable by the member is $1,750 for reasonable and customary charges per plan year. Network providers may not bill members for any charges above those considered reasonable and customary.

A PPO is a group of physicians and/or hospitals that contract with an employer to provide services to their employees. In a PPO, the patient may go to the physician of his or her choice – even if that physician does not participate in the PPO. Patients enrolled in this plan typically receive a lower benefit level, usually through higher deductibles and co-payments. PPO means Preferred Provider Organization.

Preferred Provider Organization. A PPO is a network of doctors and hospitals that contracted with a health plan and have agreed to provide their medical services at rates lower than their standard fees. A PPO offers both in-network and out-of-network benefits.

A health insurance plan with a network of physicians, but you are free to see whatever doctor or specialist you wish without needing to obtain a referral first. PPO plans usually offer coverage for out-of-network expenses once a deductible has been met.

preferred provider organization. A group that does not require that members obtain their health care only from preferred providers.

A formal agreement between a purchaser of a dental benefits program and a defined group of dentists for the delivery of dental services to a specific patient population, as an adjunct to a traditional plan, using discounted fees for cost savings.

preferred provider organization. a program that establishes contracts with providers of medical care. Providers under such contracts are referred to as preferred providers. Usually, the benefit contract provides significantly better benefits and lower member cost for services received from preferred providers, thus encouraging covered persons to use these providers. Covered persons generally are allowed benefits for non-participating providers' services, usually on an indemnity basis. A PPO arrangement can be insured or self-funded. Providers may be, but are not necessarily, paid on a discounted fee-for-service basis