Asked by Jacquelyn Gonzalez on Sep 23, 2024
Verified
Which of the following statements about preferred provider organizations (PPOs) is true?
A) Employers like PPOs because they are highly regulated.
B) Companies with at least 25 employees who live in a PPO service area are legally required to offer membership in the PPO as an alternative to regular group health coverage.
C) Employees who participate in a PPO are required to use the plan's providers exclusively.
D) Employers contract with health care providers to deliver discounted services to participants.
E) All of the above statements about PPOs are true.
Preferred Provider Organizations
Health insurance plans that offer a network of healthcare providers who provide services to subscribers at a lower cost compared to out-of-network providers.
PPO Service Area
The geographic region or locations where a Preferred Provider Organization (PPO) health insurance plan offers coverage through its network of preferred providers.
Health Care Providers
Professionals, institutions, or facilities that offer medical services, including diagnosis, treatment, and preventive care, to individuals.
- Comprehend the disparities in cost and value for firms of different magnitudes and kinds.
Verified Answer
NM
Nunzio Mancuso5 days ago
Final Answer :
D
Explanation :
Preferred provider organizations (PPOs) are networks of health care providers that have contracts with employers, insurance companies, or other payers to provide health care services to their members at discounted rates. The providers in a PPO network agree to accept lower reimbursement rates for their services in exchange for a higher volume of patients. This allows the PPO to negotiate lower rates for its members and offer more cost-effective health care coverage to employers. However, PPO members are not required to use the plan's providers exclusively, unlike Health Maintenance Organizations (HMOs).
Learning Objectives
- Comprehend the disparities in cost and value for firms of different magnitudes and kinds.