HCR 230 Assignment Features of Private Payer and Consumer-Driven Health Plans

HCR 230 Assignment Features of Private Payer and Consumer-Driven Health Plans

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Unformatted text preview: 1 Assignment: Features of Private Payer and Consumer-Driven Health Plans By Candace Terrell HCR 230 April 10, 2011 2 Most PPO plans are contracted through physicians, hospitals and pharmacies in order to provide quality services to all insured patients. These particular medical providers are the ones that abide by certain fee schedules and guidelines. PPO’s pay providers a discounted fee-for-service and patients pay annual premiums and deductibles. Also, upon the arrival to any medical service, a copayment would be due by the insured patient. An HMO is a health maintenance organization that is licensed by the state. This particular plan has the strictest rules, lower costs and slim choice of providers. Once assigned an HMO, patients are the provided with a primary care physician and have to use that provider in order to be covered by the insurance. The only exception to this rule would be an emergency situation. HMO’s were designed to cover all basic services for an annual premium and an emergency situation....
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This note was uploaded on 04/19/2011 for the course HCR 230 taught by Professor Volk during the Spring '11 term at University of Phoenix.

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HCR 230 Assignment Features of Private Payer and Consumer-Driven Health Plans

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