A) A PPO is a group of health care providers, such as doctors, hospitals, and ambulatory health care organizations, that contracts with a group to provide their services. B) Employers, insurance companies, and other health insurance benefit providers are typical groups that contract with PPOs.
Federal law requires employers with 5 or more employees to implement an HMO plan for health care coverage. Explanation. An HMO offers health care services to its subscribers and emphasizes preventive health care by providing full benefits for routine physical check-ups, immunizations, and the like.
assisted living care. Explanation. Facilities other than hospitals may provide more cost-effective treatment and care for patients. However, the care must be under the supervision of a doctor and based on a prescribed level of care.
Traditional indemnity plans provide access to any willing health care provider. Commercial insurance indemnity plans are structured on a fee-for-service basis with no requirement that a primary care physician manage care for the insured. Health maintenance organizations are known for stressing the provision of.
Health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point-of-service (POS) plans are all managed care plans that offer comprehensive medical services to their members. A primary care physician (PCP) is a physician who provides or authorizes all care for a member of an HMO.
The HMO Act of 1973 specified requirements that must be met for an HMO to receive federal qualification. For example, federally qualified HMOs must provide basic health care services and charge a community rate.