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  2. SCAN Health Plan - Wikipedia

    en.wikipedia.org/wiki/SCAN_Health_Plan

    The Senior Care Action Network, or SCAN, was created based on the proposal developed by the team at USC. (The new network was briefly known as the Long Beach Geriatric Healthcare Council, Inc., before changing its name to SCAN.) [3] Their healthcare delivery model was centered on assessing each senior's needs on an individual level in order to coordinate appropriately for each unique case ...

  3. Healthgrades - Wikipedia

    en.wikipedia.org/wiki/Healthgrades

    Specifically, most ratings are determined from multivariate logistic regressions of medical outcomes at a given healthcare provider to risk-adjust the patients and 1-, 3- and 5-star awards are given to providers whose negative outcomes are worse than expected, near predicted levels, and better than expected, respectively.

  4. Managed care - Wikipedia

    en.wikipedia.org/wiki/Managed_care

    For example, if patients stay in a network of providers and seeks a referral to use a specialist, they may have a copayment only. However, if they use an out of network provider but do not seek a referral, they will pay more. POS plans are becoming more popular because they offer more flexibility and freedom of choice than standard HMOs.

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  7. Ghost network - Wikipedia

    en.wikipedia.org/wiki/Ghost_network

    Ghost network refers to a form of healthcare insurance fraud where providers are listed as in a health insurance plan, but are unable to provide care. These ghost providers may no longer be eligible to practice, may have retired, may no longer accept new patients, may not actually part of the network, or may not exist.

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  9. Preferred provider organization - Wikipedia

    en.wikipedia.org/wiki/Preferred_provider...

    In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...

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