Distinction between HMO and PPO in medical billing [HMO PPO POS]

#medicalbilling.
#denialmanagement.
#dminmb.

HMO – HEALTH MANTAINANCE ORGANISATION.

Insurance coverage supplying economical policies to patient with low premiums and low out of pocket expenses with some T&C.
It will cover only in-network supplier visit.
For any specialist see or in emergency cases needed PCP( Primary care physician) referral.

PPO – PREFERRED SUPPLIER ORGANISATION.

Insurance providing less restriction policies to client with high premiums and high expense expense.
Patient has option to select PCP.
No recommendation needed to go to any professional or in emergency.

POINT OF SERVICE.

It is intermediate plan in between HMO & PPO. Patient has option to pick PCP. For any specialist visit or in emergency cases required PCP referral. Premiums are greater than HMO and lower than PPO.

http://medicalbillingcodingonline.org/distinction-between-hmo-and-ppo-in-medical-billing-hmo-ppo-pos/