01.Core Concepts

A preferred provider organization (PPO) is a plan that contracts with healthcare providers to provide certain medical services to members at discounted fees PPO providers typically are paid on a fee-for-service basis Patients are not required to use a preferred provider, but the deductible and co-payments are lower if they do If the provider’s actual charge exceeds the negotiated fee, the provider absorbs the excess Most PPOs do not use a gatekeeper physician ‹#›