Assignment Features of Private Payer and Consumer Driven Health Plans

Assignment Features of Private Payer and Consumer Driven Health Plans

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Assignment: Features of Private Payer and Consumer Driven Health Plans Adrienne Martin HCR/230 Beatrice Johnson
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PPO, which stands for Preferred Provider Organization, gives the patient the freedom to see any licensed doctor, the patient does not need to choose a primary care physician, a patient does not need a referral to see a specialist, and emergency and urgent care services are covered. If a patient chooses not to use a doctor in the PPO network then they are responsible for paying the full amount for the visit. Routine checkups, specialty care, hospital stays, and emergency services are covered under the plan. (CIGNA, www.cigna.com) HMO, which stands for Health Maintenance Organization, a patient is required to choose a primary care physician, referrals can be difficult to obtain for a specialist, and emergency care and hospitalization are covered. Some claims might be denied based on profit instead of the patient’s quality of health. (Health Insurance Center, www.insurancehelp.php.htm)
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Assignment Features of Private Payer and Consumer Driven Health Plans

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