A person receiving health care insurance from his employer knows that he should check the approved list of contracted health care providers before seeking services, in order to receive them at a lower cost. What type of insurance is most likely involved?
A) Medicaid
B) Preferred provider organization
C) Health maintenance organization
D) Long-term care insurance
Ans: B
Preferred provider organizations (PPOs) allow a third-party payer (agencies that pay health care providers for services provided to individuals, such as a health insurance company) to contract with a group of health care providers to provide services at a lower fee in return for prompt payment and a guaranteed volume of clients and services. Although clients are encouraged to use specific providers, they may also seek care outside the panel without referral by paying additional out-of-pocket expenses.
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