Ppo vs

In: Other Topics

Submitted By dmathe21
Words 327
Pages 2
A Preferred Provider Organization (PPO) provides financial incentives for patients to use designated health care providers, but also provides coverage for services rendered by health care providers who are not part of the PPO network. Financial incentives for individuals to use preferred providers include lower copayments or coinsurance and limits on out-of-pocket costs when using in-network providers.

Point-of-Service (POS) plans may be offered by managed care organizations or traditional indemnity insurers. POS plans provide financial incentives for using network providers (for example, a fixed copayment instead of a 20 or 30 percent coinsurance rate). However, a POS option allows you to go outside the network and see any doctor you choose without a referral. If you do utilize non-network providers, expect to pay a substantial portion of the bill yourself. The POS plan will pay its share based on discounted fees it negotiates with doctors and will take into consideration deductibles and coinsurance before it determines the payment.

What Does This Mean to You?

Consider a PPO if:HMO
You want to keep your health care options open.
You want more freedom of provider choice.
You want to "self-refer" to specialists.
You don't mind having larger out-of-pocket expenses and/or employee contributions.
Your doctor is not a member of the network, and you don't think you would be happy with another type of plan, such as an HMO.

Consider a POS Plan if:
You like the features of an HMO but also want an "escape." For example, you want to have the ability to visit a renowned medical facility, for example, if you felt you weren't receiving quality care from your Primary Care Physician.
You travel outside the plan's service area or have dependents living out of state.
Your current doctor and specialist are members of the network.
You want to keep your costs for…...

Similar Documents

Assignment on Grameenphone vs Banglalink

...exploit the potentials | |that include – banking service solution, order-purchase platform, remittance services & many more and Banglalink made the first | |effort with the award winning services like - M-banking, M-remittance and Krishi Bazar. These services requires improvement. | |Moreover, popularizing and educating - are the mandatory necessities. Once the people start to accept the services, the brand | |preference for Banglalink over its competitors is inevitable.s share and make the best use of our short spanned life.] | | | Case Study on Grameenphone vs. Banglalink GRAMEENPHONE VS BANGLALINK - A CASE STUDY ON THE TWO TELECOM GIANTS OF BANGLADESH IN CONSIDERATION OF BOTH COMPANIES' BUSINESS CHALLENGES, SCOPES & STRATEGIC APPROACHES . CHAPTER ONE: INTRODUCTION Human history provokes the communication as a very important event in regular life of the people. Since then to make communication easier people has been working on it and finally in the present we see the birth of the initial maneuver and that is the wireless telecommunication. Bangladesh is not far away from such technological involvements, compared with the rest of the world, and has seen a rapid boom in the mobile industry. Within the last nine years, the user base of mobile phones has skyrocketed......

Words: 8650 - Pages: 35

Unix vs Ms vs Mac

...Running head: UNIX vs. MS vs. MAC 1 CIS-155 Final - UNIX vs. MS vs. MAC UNIX vs. MS vs. MAC 2 Abstract This paper will explore the history of UNIX, Microsoft (MS), and Macintosh (MAC) operating systems. Not only will I discuss the history of these systems, but I will also dive into the pros and cons of each. The benefits of each over its rivals will also be discussed. Keywords: open source, UNIX, Windows, UNIX vs. MS vs. MAC 3 The topic of what operating system is best has been a long and heated one. But, in the long run, UNIX will beat its rivals in most categories hands down. As the reader will see throughout this paper, undisputed evidence will be presented that will detail exactly how UNIX based operating systems are superior. Operating systems (OS‘s) are a means for users to communicate with the computer. Each OS provides a set of commands for directing the operation of the computer. Without these operating systems to help as interfaces, each user would have to learn the command syntax, which can be very difficult. These operating systems can be menu-driven, which provides a set of menus and lets users choose desired functions from then, or they can be icon-driven, known as a graphical user interface (GUI). GUIs are very common these days and with them, users can choose an icon, usually with a mouse, to......

Words: 1794 - Pages: 8

Vs Cultural

...West-Europese landen. Ongeveer 55% van de bevolking is protestants, 25% is katholiek, 2% is joods en 1% is moslim. 15% heeft geen religie. De VS is het machtigste land ter wereld, dit als gevolg van het militaire, economische en culturele overwicht. De reacties op het Amerikaanse beleid, als gevolg van de politieke en culturele invloed, zijn vaak heftig. Deze variëren van bewondering voor alles wat Amerikaans is tot anti-Amerikanisme. Vooral de Amerikaanse steun aan Israël is een steen des aanstoots in de islamitische wereld. De economie van de Verenigde Staten is de grootste nationale economie ter wereld en bedraagt 14,6 biljoen dollar (bbp 2010). De economie is vooral gebaseerd op diensten, meer dan 75% van de Amerikanen werkt in de dienstensector. Belangrijkste handels partners zijn Canada, Mexico, Japan, Duitsland, Verenigd Koninkrijk en Zuid Korea. De Verenigde Staten hebben ook de grootste staatsschuld ter wereld4 (27-12-2012: 16,3 biljoen dollar). Door het oplopende begrotingstekort is de staatsschuld de laatste jaren flink opgelopen. China is de grootste krediet verstrekker van de Verenigde Staten en heeft voor 1,16 biljoen dollar aan Amerikaanse staatsobligaties in bezit. Het land heeft een strek negatieve handelsbalans, deze is vooral te danken aan de import van olie/energie. Voor 2013 wordt de groei van de energiesector in de VS gezien als ,,de belangrijkste kracht voor de stimulering van de wereldwijde economische groei in de toekomst'' (Huang Guobo, 2013).......

Words: 4917 - Pages: 20

Associate Nursing Degree vs. Diploma vs. Baccalaureate

...Associate Nursing Degree vs. Diploma vs. Baccalaureate Which is the Future Lena Slater-Everhart Grand Canyon University Professional Dynamics NRS-430V Professor Rhonda Johnston October 07, 2013 Associate Nursing Degree vs. Diploma vs. Baccalaureate The debate of different levels of education has gone on for years. The existence of three entry level educational programs—diploma, associate, and baccalaureate degree, all leading to registered nurse licensure and beginning positions—has led to confusion among the public and the profession as to the exact requirements for a credential as a professional nurse.( Creasia, & Friberg (2011).)The historical origins of nursing developed into the diploma programs based at hospitals. Yes, I believe is a difference in the educational experience between the Associate Nursing Degree, diploma and the Baccalaureate prepared nurse. Each level of nursing education has had a part of the development of what nursing is today. The nursing shortage has also contributed to the different education levels in the attempt to provide staff in the nursing field Creasia) The associate degree nursing program consists of two years of schooling and clinical experience. The programs are connected to community colleges, technical schools, and some Universities. The programs consist of teaching nursing information, the sciences, and general education to support then nursing curriculum. The programs touch on evidence –based making, but do not emphasize...

Words: 939 - Pages: 4

Egyptian vs Persian vs Asyerian

...Egyptian vs. Persian vs. Assyrian Similarities and differences can bring two or more things together or make them separate or not anything at all. For example, the Egyptian, Persian, and Assyrian empires were similar in some ways and different in others, but they didn’t harm each other. The Egyptian, Persian and Assyrian empires are similar by their military, organization of government, and innovations. All three empires had a military. Although they were organized differently, they all consisted of the same things. Their military had officers and soldiers, and the best soldiers were the ones that led the troop into battle. Furthermore, the governments were organized by hierarchy, or from the highest ranked to the lower ranked officials. In all three empires, they had someone appointed as a king, governors and as “vice king”. In addition, the empires made some innovations; their innovations weren’t similar, but the fact that they made innovations makes them similar in some way. For instance, the Egyptians made mosaic glass, and practiced medicine and mummification. Plus the idea of coined money was spread by the Persians. Finally, the Assyrians were the most common empires that built sculptures, and painted stonework. Even though they weren’t similar with specific details, the three empires were similar. The Egyptian, Persian, and Assyrian empires are different by their religion and their type of government. The Egyptians were polytheistic, or that they believed in......

Words: 330 - Pages: 2

Creationism vs

...Creationism Vs. Evolution in Today’s Society The dispute between creationism and evolution is a long debated controversy. It is an argument most people choose to avoid. This debate is extremely controversial due to personal belief, most in part due to secularism and religion. Even with the exponentially increasing knowledge of today, it has remained a long fought controversy throughout the twenty-first century. Science deals with the mind, and is the backbone of modern civilization. Religion deals with emotions, and often teaches people invaluable ethical principles. Both Science and Religion are vital in our culture in order for humanity to progress. In order for society to progress, children should be taught about both evolution and creationism, and taught to question both theories. As a result, our children will be open-minded and have the skills to “think outside of the box”. The theories of today and from the past are ones regarding strong factual evidence that has been extensively tested through the scientific method. The Theory of Evolution states that life has evolved from simple, single-celled organisms that all share a common ancestor. Throughout history these organisms faced the challenges of survival, and because of this, became more complex. Different stimuli, in different parts of the world, cause organisms to evolve differently. When these different simple organisms meet, there is often competition between the two in order to reproduce and/or survive. This......

Words: 1213 - Pages: 5

Epigenetics-vs-Nature-vs-Nurture

...Epigentics vs Nature vs Nurture Santina Wood ENG101 Argosy University 03/4/2014 Instructor Benjamin Atkins Epigenetics -vs- Nature -vs- Nurture The nature vs nurture debate is still ongoing, and within this debate, the world of science and psychology are faced with two new questions. Today we find some researchers asking; "Is development predetermined at birth, by hereditary factors, or do experience and other environ -mental factors affect it?", and "Can the two work together in shaping human development and behavior?" Developmental psychologists still attempt to find the answers to these questions in order to discover the sources of growth in children's cognitive, language, and social skills. Most developmental psychologists believe that nature and nurture combine to influence biological factors playing a stronger role in some aspects, such as physical development, and environmental factors playing a stronger role in others, such as moral development. They are also beginning to acknowledge the role of a variable combination of both inborn factors and social experiences when explaining children's behavior. Scientists and Psychologists have a name for such an occurrence; epigenetics/epigenesis. In this essay, I will be presenting to my audience information on this highly, and sometimes heated debate, as well as the reasons as to why the belief of this dual influence called epigenetics is becoming more fact than theory. For...

Words: 1643 - Pages: 7

Acrual vs

...Accrual vs. Cash Thomas Warren Brow 2 October, 2014 HSM/260 Sara Stevens In cash accounting you only show transactions that are cash in or cash out transactions, and for a non-profit agency that does not show enough. The accrual method shows all transactions whether they are cash, credit, insurance, or check. In this system it keeps all monies out in the open, and stops any hidden monies from appearing out of nowhere and shows all monies and what is being done with them and how they are generated. The accrual takes the steps necessary to ensure that the agency has a clear and accurate account of any spending the agency does. In the accrual system you taken into account and record any revenue when the transaction occurs or a deal is made even in the event that there is no cash received, and more often than not the revenue and cash will not equal each other when this method is used. If the method of payment is cash when the service is rendered than it will be recorded the same, but if it is a credit payment that makes your revenue go up but your cash is the same then this is a case where the revenue and cash do not equal each other. ("Does Revenue Equal Cash In An Accrual System?", 2014) It is vital because statement of cash flow is the last document that is done for the finances and gives a flow of information which adds validity and accountability to financial records of the company. All people who fund an agency use these records to see what they are funding......

Words: 354 - Pages: 2

Mac vs Microsoft vs

...for the process. Each task also holds the execution state, which can be running, interruptible, uninterruptible, stopped, zombie. Linux takes the user level threads for the tasks and can map them to kernel level processes with the same group ID. This offers resources sharing and security. Mac operating systems handle the execution of processes even differently than Windows and Linux. Mac has Grand Central Dispatch, which contains a pool of available threads. “Thread pools are automatically sized by the system to maximize the performance of the applications using GCD while minimizing the number of idle or competing threads” (Stallings 2012). Programs are intended to create blocks, which contain data and code on how to perform. “Windows vs. MAC vs. Linux OS will provide as much concurrency as possible based on the number of cores available and the thread capacity of the system” (Stallings, 2012). The development of these blocks is formatted in files and will run in concurrency using first-in-first-out processing. The merging process in the Grand Central Dispatch is well-organized in most cases compared to manually handling threads. Looking at UNIX/Linux it has one advantage over other operating systems on the market. It is less used than other operating systems. That fact alone improves the security of the operating system because the less hackers are trying to attack the system, the more secure it will be. Linux utilizes a firewall to block anyone trying to hack into the......

Words: 2337 - Pages: 10

Cccac vs

...car it is a triumph of the emotions over the logical mind. Even the remake of The Italian Job, a pale shadow of the Michael Caine original, did not take the edge off all of that fun factor. Downloaded by Myongji University At 05:37 14 May 2015 (PT) ´ (A precis of the article “An analysis of the repositioning of the “BMW Mini” brand”. Supplied by Marketing Consultants for Emerald.) To purchase reprints of this article please e-mail: reprints@emeraldinsight.com Or visit our web site for further details: www.emeraldinsight.com/reprints 309 This article has been cited by: Downloaded by Myongji University At 05:37 14 May 2015 (PT) 1. Laura Illia, Johan van Rekom. 2013. Identity Concerns or Functional Concerns? High vs Low Identifiers Reaction to Brand Identity Change. Corporate Reputation Review 15, 52-67. [CrossRef] 2. George Baltas, Charalabos Saridakis. 2009. Brand‐name effects, segment differences, and product characteristics: an integrated model of the car market. Journal of Product & Brand Management 18:2, 143-151. [Abstract] [Full Text] [PDF] ...

Words: 10657 - Pages: 43

Diploma vs Associates vs Bachelor Degree Nrses

...Diploma vs. Associates vs. Bachelor Degree Nurses Louanne Adkins RN Grand Canyon University: Nursing History, Theories, and Conceptua... June 6, 2015 I have seen and experienced a wide variety of differences among the 3 types of degrees available, diploma vs. associates vs. bachelors. Myself, as a three year diploma nurse, I believe that I encountered more of a “hands on approach” to clinical skills versus the “book smart” bachelor approach versus the combination program of the associate’s degree. My diploma program started day one with patient interaction, from vital signs to baths. I discovered the bachelors program was mainly book work until the fourth year, at which time clinicals were initiated. The current trend and future of nursing is having a bachelor’s degree. I believe that this is due to the greater exposure to management skills on a daily basis that nurses now face. Previously there was a direct line from the doctors, who made the decisions, to the nurses that did as they were instructed. As the nursing processed evolved, nurses were empowered and started becoming a patient advocate, this came as a direct route of the education nurses received. Nurses have come to earn the respect of their coworkers and doctors that they have worked with. I had the experience of starting my first job out of nursing school on a med-surg floor on second shift with two other new grads. One was an associate degree grad while the other...

Words: 852 - Pages: 4

Nature vs

...Psychology 1000 10/11/12 Nature vs. Nurture In the field of psychology there is a large controversy on whether nature or nurture affect who we are or who we will become. Those who favor nature will argue that our intelligence, personality traits and capacity to achieve goals are largely influenced by genetics. On the other side, people who put forward the idea of nurture will say that it is the environment we live in that shapes who we become. According to John Watson, a strong psychologist who proposed environmental learning as a dominating side, he can be able to train a baby randomly chosen in a group of 12 infants, to become any type of specialist he wants. As of now, we know that both nature and nurture play important parts in molding an individual; however, environmental factors are the real origins of our behavior. There are many examples that can be given to support Watson’s behavioristic views and theories. For instance, identical twins have very remarkable similarities; however when raised in two completely different environments, for example how accessible resources are to each of them, private school versus public school, cause several differences in the way they think and behave. Also, how well a parent takes care of his child and how safe the environment surrounding the family is, affects the child’s behavior and decision-making skills. Also, often children who have been raised in a stable and safe environment, with lots of affection from their parents......

Words: 317 - Pages: 2

Nature vs. Nurture vs. Tofu

...Nature vs. Nurture vs. Tofu 2 Without conducting any research, I realize that I have never really thought about the subject of nature vs. nurture. By knowing a little of what the controversy is about, I am able to ask myself the right questions to complete my thoughts and come to a proper opinion. Usually I am an extremist by going with one side and not lingering with thoughts in the middle. However, this is a subject that does not deserve one end. By looking and observing those around me, many may notice that people share similar traits. Some traits are the result of nature and others are the result of nurture. There is no 50:50 ratio that is involved in the deciding factor of how much of each side contributes to the individuals we are today. Because biological factors and conformity are two different subjects, there is no scientific way to measure an accurate ratio of nature to nurture. Instead, I believe that each and every person is the product of 100 percent nature as well as 100 percent nurture. As my boyfriend and I are out to lunch, I throw my thoughts at him about nature vs. nurture and he makes me realize that tofu is a great example of both nature and nurture. He asks me how I am able to eat something so bland and tasteless. I tell him that tofu does have sort of a creamy nutty taste to it and is delicious plain uncooked. However, when tofu is cooked, it conforms to and picks up the flavor of the food or sauce that is being cooked......

Words: 1274 - Pages: 6

Data vs Fixed Line vs Cellular Debate

...Jimmy Johnson NT1310 Monday Night Unit 1 Lab 1: Data on Fixed Line vs. Cellular Debate As many as one in six American households have given up their landline and are using only their cell phone, according to Steven Blumberg, a senior scientist at the Center for Disease Control’s Statistics department. If you are among the millions of Americans who are weighing the pros and cons of landlines vs. cell phones, here are a few things to consider. Cost: The most common reason to choose a cell phone is that in most areas, the cost of a cell phone plan is lower than the cost of a landline, especially when you count the cost of a long distance calling plan. However, the “per month” cost that many carriers quote can be misleading. As you compare the cost of a cell vs. a landline, consider these factors: •Do you need any services that aren’t covered in this plan? For example, will you be taking your cell phone out of the call area (i.e. roaming)? Does the cost of your landline plan include voice mail and caller ID? •Does your cell phone plan require a multi-year contract commitment? If so, what is the cost of ending your contract? •How much time do you spend talking on the phone, and when do you make your calls? Some providers offer free incoming calls, or free nights and weekends, but those aren’t helpful if you make lots of outbound calls during business hours. •How many people will use the phone? If you have a large family, you can ensure that everyone has a cell......

Words: 786 - Pages: 4

Hmo vs Ppo

...Analysis of Problem Advantages and disadvantages concerning HMOs and PPOs have already been explained, however, understanding the purpose of HMOs and PPOs and how they came about and have evolved will shed light on several of their characteristics. The history, the need, and the evolution of each has influenced managed care so being familiar with background of each will help determine with plan would be best for the employer and the employees. The first HMO that has been documented in history started in the year 1910 in Tacoma, Washington and the name of the clinic was The Western Clinic. For a premium payment of $.50 a month, the clinic offered a variety of services and treatment to lumber mill owners and their employees (Kongstvedt, 2007). The clinic created this type of plan so ensure that they would have a steady flow of patients and by creating a premium, it brought patients back without having to create other strategies to retain patients. This constant flow of patients is where the need of HMOs began. An HMO is “an organization that combines the provision of health insurance and the delivery of health care services” (http://www.rand.org/pubs/rgs_dissertations/RGSD172/RGSD172.ch1.pdf). This is where HMOs have their strength, by providing healthcare services to patients and by providing patients to healthcare providers. Clinics and hospitals favored the idea and wanted to adopt the same concept and create their own original HMOs with the same goal in mind; to......

Words: 853 - Pages: 4