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 Posted: Mon Aug 04, 2008 4:49 pm Post subject: What is a PPO? |
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What is a PPO? What are PPO Codes?
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| Posted: Mon Aug 04, 2008 6:59 pm Post subject: |
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| I know it as Prefered (or Participating) Provider Organization. It's a managed care health plan. I've never heard of "PPO Codes". |
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tcope
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| Posted: Tue Aug 05, 2008 5:43 am Post subject: |
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PPO is a form of managed health care plans, designed to offer discounted or subsidized healthcare benefits to the beneficiaries of this plan. This system offers the benefit to the member to choose from the wide network of health care providers for his health related needs.
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Juanita |
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Juanita
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| Posted: Tue Aug 05, 2008 5:58 am Post subject: |
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the PPO is pretty similar to HMO, but offers more flexibility by allowing the member to visit a doctor outside the network. With PPO plan you are required to make regular monthly payment to enjoy the health coverage benefits.
However, with PPO you're not required to obtain the referral from the primary care physician in order to visit a specialist. You can also consult a doctor of your choice only by bearing a larger share of the expense.
~Jeremy |
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JeremyHolter
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| Posted: Wed Aug 06, 2008 4:41 am Post subject: |
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The most important things to know about PPOs is:
You can go to any doctor.
You will be charged extra if you go outside of your network.
No extra charges for non-emergency treatment when out-of-network
In contrast an HMO will not pay anything if you seek care outside of the network, unless the charges are for treatment that was classified as an emergency.
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Alston
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| Posted: Wed Aug 06, 2008 5:04 am Post subject: |
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PPO insurance is a Managed Care health plan. You can read about it here: PPO Health Insurance. It is a mixture of the Indemnity plan and HMO plan.
links removed as per forum rules
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TheInsuranceFiles
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Alston
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| Posted: Tue Aug 12, 2008 4:55 am Post subject: PPO Codes |
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Supposedly, these are the PPO codes: 65, 71, 72, 73, 74, 75, 76, 81, 82, 83, 84, 85, 86, 91, 92, 93, 94, 95, 96, J1, J2, J3, J4, J5, J6, J9, LC, LD, LE, LM, LN, LO, N8, N9, O1, O2, P3, O4, O5, O6, O9, P8, P9, P0, RK, RM, RN, RO, RQ. I had never heard of them myself but I found one website that had them listed. It appears that these are the "PPO codes" for CommunityCare of Oklahoma. The codes are listed on the actual insurance card of the policyholder and each code corresponds with a specific package that is offered. For example, code 65 is their "Value Advantage 2 Plus (80/50)" plan. I guess they are just asking for what types of packages are offered with a PPO plan? Not entirely sure, but those are what PPO codes look like. Sounds to me like that is more of a specific healthcare company jargon that breaks down their ID card numbers or something so they know what kind of plan they are dealing with when the customer calls in and says their account number.
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TheInsuranceFiles
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| Posted: Sat Aug 23, 2008 5:41 am Post subject: |
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| Me too haven't heard about the PPO codes ? I think what insurance files is trying to say is only limited to a few states .. |
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renditioner
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| Posted: Sat Aug 23, 2008 9:01 am Post subject: |
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Excellent information, InsuranceFlies. I never knew that such thing exists.
However, to me the numbers seem more like random (may be they are not  ) Can you just share some more information regarding the PPO codes.
What are the other states that apply such policy of identification? or, is it specific to Oklahoma??
~Jeremy |
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JeremyHolter
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