Exclusive Provider Organization definition

Exclusive Provider Organization. (EPO) means a health insurance issuer's or carrier's insurance policy that limits coverage to health care services provided by a network of providers who are contracted with the issuer or carrier.

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Exclusive Provider Organization or “EPO” means a type of managed care health plan where

Exclusive Provider Organization or “EPO” means a type of managed care health plan where members are not required to select a primary care provider or receive a referral to receive services from a specialist. EPOs will not cover care provided out-of-network except in an emergency.

Examples of Exclusive Provider Organization in a sentence

In this section, a Plan that pays providers based upon capitation is called a “Capitation Plan.” In the rules below, “provider” refers to the provider who provides or arranges the services or supplies and “HMO” refers to a health maintenance organization plan, and “EPO” refers to Exclusive Provider Organization.
In this section, a Plan that bases benefits on a negotiated fee schedule is called a “Fee Schedule Plan.” An HMO and Exclusive Provider Organization (EPO) are examples of network only plans that could use a fee schedule.
In this section, a Plan that pays providers based upon capitation is called a “Capitation Plan.” In the rules below, “provider” refers to the provider who provides or arranges the services or supplies and “HMO” refers to a health maintenance organization plan and “EPO” refers to Exclusive Provider Organization.
Preferred Provider Organization (PPO), Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) medical plans, and PPO and Dental Maintenance Organization (DMO) dental plans shall be available to employees.
As of implementation of the changed plans in 2010, the only such plans are the Preferred Provider Organization (PPO) plan, the Exclusive Provider Organization (EPO) plan, and the Basic Exclusive Provider Plan (Basic EPO) with plan designs attached and identified as PPO, EPO and Basic EPO.
The CSAC-EIA provides Anthem Exclusive Provider Organization (EPO) coverage, Anthem Choice Preferred Provider Organization (PPO), Anthem Select PPO, Anthem Choice PPO Out of State (OOS) coverage plans and Choice Medicare Supplement and Choice Medicare Supplement OOS coverage.
Insureds enrolled under SHL’s Exclusive Provider Organization (EPO) Plans who use the services of Non-Plan Providers will receive no benefit payments or reimbursement for amounts for any Covered Service, except  in the case of Emergency Services or Urgently Needed Services or  other Covered Services provided by a Non-Plan Provider that are Prior Authorized by SHL’s Managed Care Program.
The District will provide health insurance through the Blue Cross EPO (Exclusive Provider Organization) and the Blue Cross PPO (Preferred Provider Organization) plans.
Exclusive Provider Organization — Pursuant to Chapter 627, F.S., a group of health care providers that have entered into a written agreement with an insurer to provide benefits under a health insurance policy.
The District shall offer health insurance with at least: One Exclusive Provider Organization (EPO) Beginning with the February 1, 2021 paycheck the District shall pay seventy-five percent (75%) of the EPO premium for Employee Only coverage and seventy percent (70%) for all other premium tiers of the plan (employee + spouse, employee + child(ren) and family).

More Definitions of Exclusive Provider Organization

Exclusive Provider Organization. (EPO) means an Exclusive Provider Organization, as defined in California Code of Regulations, Title 10, Section 2699.6000(r).

Exclusive Provider Organization or "EPO" means any arrangement, other than a health maintenance organization, limited health service organization, voluntary health services plans, or a DHCSP, under which the beneficiary receives no coverage or benefits when utilizing non-preferred providers, except when such an arrangement is shown to be in the best interest of the beneficiaries and has been expressly approved by the Director in writing. WC PPPs are not a form of EPO.

Exclusive Provider Organization. (EPO) means an Exclusive Provider Organization, as defined in Section 2699.6000(r) of Title 10 of the CCR a health insurance issuer’s or carrier’s insurance

Exclusive Provider Organization or “EPO” means a type of managed care health plan where members are

Exclusive Provider Organization means a managed care plan organized as an insurer that provides access to nonemergency cover ed health care services only through a contracted panel of participating providers, whose reimbursement includes prepayment, withholds, capitation, or other risk-sharing arrangements;