Healthcare Billing Solutions
Two of the biggest healthcare plans are Health maintenance organizations (HMOs) and preferred provider organizations (PPOs).
Health Maintenance Organizations (HMOs)
An HMO is a type of health plan that often has lower monthly premiums and out-of-pocket costs, like copayments and deductibles. HMOs only cover health care services given by doctors and hospitals in the plan’s provider network. Not all HMO plans are the same. Some HMOs may have a smaller network and lower monthly premiums than other HMOs.
Preferred Provider Organizations (PPOs)
A PPO is a type of health plan that gives you the most flexibility, in most cases, but often has higher monthly premiums and out-of-pocket costs, like deductibles and coinsurance, than other plans. Like HMOs, each PPO uses a certain network of doctors, specialists and hospitals. Some lower-cost PPOs have fewer doctors and hospitals than other more costly PPOs and some HMOs.
It is important to know that if medical care is obtained from outside of their established networks, HMOs and PPOs may deny your payment claim or even cut down your benefits. Healthcare Billing Solutions will be able to work with you to ensure that you significantly reduce this risk.