PPO (preferred provider organization)
This plan is somewhat similar to indemnity plans. It offers you the freedom to access the doctor of your choice. (Costs are lowered within a given network however) If you travel outside the network, you will be forced to pay a copayment based on higher charges. In addition, you might also be forced to pay the difference between the fee and the amount covered by your specific health insurance plan.
POS (point-of-service)
A POS health insurance plan is one of the more expensive insurance plans to choose from. Within a POS health insurance plan, you have a primary care physician (PCP) who has the ability to refer you to other providers within the given health insurance plan. If your PCP refers you to a physician outside of the network, all or most of the bill will be covered by your POS plan. Within the POS plan you also have the option to refer yourself outside of the network. However, in such instances, you would have to pay coinsurance.
Medicare Payments, Reimbursement, Billing Guidelines, Fees Schedules , Eligibility, Deductibles, Allowable, Procedure Codes , Phone Number, Denial, Address, Medicare Appeal, EOB, ICD, Appeal.
Medicare Guideline posts
- Home
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation process - how often provide need to do - FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
Subscribe to:
Post Comments (Atom)
Top Medicare billing tips
-
Procedure code and Description 92540 Basic vestibular evaluation… 92541 Spontaneous nystagmus including gaze and nystagmus, with reco...
-
CPT CODES and Description 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitr...
-
procedure code and description 93922 LIMITED BILATERAL NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, (EG, FOR LOW...
-
Procedure code and description 11400- Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms or legs; lesion d...
-
Patient Discharge Status Code - Definition A patient discharge status code is a two-digit code that identifies where the patient is at th...
-
Procedure code and Description 92002 Ophthalmological services: medical examination and evaluation with initiation of diagnostic and trea...
-
CPT CODE and description 99243 - Office consultation for a new or established patient, which requires these 3 key components: A detailed h...
-
99231 : Inpatient hospital visits: Initial and subsequent subsequent hospital care, per day, for the evaluation and management of a pat...
-
CPT CODE and description 87880 - Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group A...
-
Procedure code and description 95806 - Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory air...
No comments:
Post a Comment