(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.
Your Comment / Review:
By submitting your comment, you agree to the following - All reviews and comments undergo rigorous screening and must adhere to our strict guidelines of ethics. We do not condone anything that is slanderous, disparaging,
derogatory, offensive, prejudicial, insulting or simply rude. We will remove any comments that do not follow or meet these guidelines. NPIdb.org wants to encourage your right to free
speech however we must also protect the reputation of the physician in question and make every effort so that no one is harmed by such careless remarks. When leaving a negative comment,
please be tactful, objective and, if at all possible, polite. NPIdb.org reserves the right to remove any comment or review for any reason and without notice. Please do not abuse this privilege.