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In the United States, an exclusive provider organization (EPO) is a hybrid health insurance plan in which a primary care provider is not necessary, but health care providers must be seen within a predetermined network. Out-of-network care is not provided, and visits require pre-authorization.
Blue Shield was developed by employers in lumber and mining camps of the Pacific Northwest to provide medical care by paying monthly fees to medical service bureaus composed of groups of physicians. [9] [10] In 1939, the first official Blue Shield plan was founded in California. In 1948, the symbol was informally adopted by nine plans called ...
Unlike EPO members, however, PPO members are reimbursed for using medical care providers outside of their network of designated doctors and hospitals. However, when they use out-of-network providers PPO members are reimbursed at a reduced rate that may include higher deductibles and co-payments, lower reimbursement percentages, or a combination ...
EPO. An Exclusive Provider Organization plan, like a POS, combines different facets of basic HMO and PPO plans. Unlike POS and HMO plans, however, EPOs allow you to choose your own PCP and see ...
In 1999, Anthem acquired Blue Cross and Blue Shield of New Hampshire and Blue Cross and Blue Shield of Colorado and Nevada. The acquisitions made since 1996 added 850,000 policy holders. Among its customer base were 2.4 million PPO and 964,000 HMO enrollees. [20] In 2000, Anthem acquired Blue Cross Blue Shield of Maine. [21]
Blue Cross Blue Shield (BCBS) is an association of insurance companies in the United States that offer Medicare Advantage in every state, Washington D.C., and Puerto Rico. Glossary of Medicare terms
Blue Shield of California is a mutual benefit corporation and health plan [6] [7] founded in 1939 by the California Medical Association. It is based in Oakland , California, and serves 4.5 million health plan members and more than 65,000 physicians across the state.
AmeriHealth New Jersey provides employer on-site health coaching with a nurse wellness specialist to small- and mid-sized New Jersey–based organizations. Workplace wellness services include sending registered nurses to provide a broad spectrum of on-site health education, seminars, screenings, and support.
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