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

#medicalbilling.
#denialmanagement.
#dminmb.

HMO – HEALTH MANTAINANCE ORGANISATION.

Insurance coverage supplying economical policies to client with low premiums and low out of pocket expenses with some T&C.
It will cover just in-network supplier visit.
For any specialist visit or in emergency situation cases needed PCP( Primary care doctor) recommendation.

PPO – PREFERRED SUPPLIER ORGANISATION.

Insurance coverage offering less constraint policies to patient with high premiums and high expense cost.
Client has choice to choose PCP.
No recommendation required to visit any specialist or in emergency situation.

POINT OF SERVICE.

It is intermediate strategy between HMO & PPO. Client has option to select PCP. For any specialist see or in emergency situation cases required PCP recommendation. Premiums are higher than HMO and lower than PPO.

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