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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.
John Rowe, chief executive officer of Aetna from 2000 to 2006 [27] V. J. Skutt, president and chief executive officer of Mutual of Omaha until 1984, [28] later named chairman emeritus [29] Brian Thompson, chief executive office of UnitedHealthcare from 2021 until his killing in 2024 [30] Bernard Tyson, former chief executive officer of Kaiser ...
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 addition to their own research, health insurers Aetna, [15] [16] [17] Humana [18] and UnitedHealth Group [19] have all provided their own claims data for independent analyses by the Health Care Cost Institute. [20] The RAND Health Insurance Experiment (1974–1982) is considered "one of the best experimental social science studies ever ...
Exclusive provider organization (EPO) Health maintenance organization (HMO) Preferred provider organization (PPO) Medical underwriting; Health care reform law.
Hackensack Meridian Health, locked in a contract dispute with Aetna, has sent letters to the insurer's customers warning them that they may lose in-network coverage if the two sides can't reach a ...
Examples included litigation between Aetna and a group of surgical centers over an out-of-network overbilling scheme and kickbacks for referrals, where Aetna was ultimately awarded $37 million. [25] While Aetna has led the initiative, other health insurance companies have engaged in similar efforts.
Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor ...
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