PREFERRED PROVIDER ORGANIZATION (PPO) (40)    TYPE OF PLAN (355.1)

Name Value
NAME PREFERRED PROVIDER ORGANIZATION (PPO)
ABBREVIATION PPO
MAJOR CATEGORY PPO
DESCRIPTION
An entity that serves as a broker to contract for comprehensive
health care services, with both hospitals and physicians, on
behalf of an employer or other group of patients,
at prearranged discounted rates or on a fee schedule.
EFFECTIVE DATE
  • GROUP CODE:
    • Patient Responsibility
      REASON CODE:
      • 1
        PART A PERCENTAGE:   100
        PART B PERCENTAGE:   100
      • 2
        PART A PERCENTAGE:   100
        PART B PERCENTAGE:   100
      • 3
        PART A PERCENTAGE:   100
        PART B PERCENTAGE:   100
    • Contractual Obligations
      REASON CODE:
      • 45
        PART A PERCENTAGE:   0
        PART B PERCENTAGE:   100