Difference between HMO, EPO, POS and PPO Plans in Medical Billing

Hello All Readers,

I am Anees and I have 4 years experience in Medical Billing and I will guide you about different plans in Medical Billing. So, lets start

HMO Plan

HMO Plan is the Cheapest Plan in Healthcare.

In HMO Plan need to select Primary Care Provider(PCP) and Patient has to got to that same Provider for services.
Only In Network services are covered. There are no Out of Network Benefits.

EPO Plan

This Plan is expensive than HMO Plan

No Need to select PCP

No need of Referrals

You can see any Provider in the Network

POS Plan

Expensive Plan than HMO and EPO

You can choose PCP for services
In Network Services are covered but some Out of Network Services are also covered

PPO Plan

Most Expensive Plan
No Need to Choose PCP

No need of Referrals

In Network and Out Of Network Services are covered

 

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