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In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
[4] [5] This new health care model was built around a network of participating providers and was a precursor to today's preferred provider organization (PPO). [5] [6] In order to expand its presence in the upstate New York market, GHI established GHI HMO as an incorporated [clarification needed] entity in May 1999. [5]
Prior to June 2022, Elevance Health was named Anthem, Inc. [2] The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Anthem Blue Cross in California, [3] Wellpoint, and Carelon. [4]
In 1939, Blue Cross Plans united to form the Blue Cross Association [7] In 1956, Medical Mutual of Cleveland was formed to provide coverage for doctor fees. CHSA merged with Akron Hospital Service to form Blue Cross of Northeast Ohio in 1957, and four years later, Medical Mutual of Cleveland became affiliated with the Blue Shield system.
One example is the convergence of preferred provider organization (PPO) plans offered by Blues and commercial insurers and the point of service plans offered by HMOs. Historically, commercial insurers, Blue Cross and Blue Shield plans, and HMOs might be subject to different regulatory oversight in a state (e.g., the Department of Insurance for ...
It combines characteristics of the health maintenance organization (HMO) and the preferred provider organization (PPO). [1] The POS is based on a managed care foundation—lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans.
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