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Appendix EDirectory of PPOs 265
The PPOWhat It Is
Expenditures by Source of Funds for Selected Years
15 other sections not shown
administrator admission approach appropriate assessment BLUE CROSS California capital cent cians claims processing competitive concurrent review consumer Contact Person contract corporation coverage criteria delivery system diem discounts employer entity ERISA established evaluation federal fee-for-service health care costs health insurance health maintenance organization Hospital Services hospitals and physicians incentives insurance company insurance payor issues joint venture liability marketplace Medicaid medical necessity medical services medical staff Medicare ment methodology Nature of Sponsorship necessary negotiated offer Operational Nature organizational Participating Hospital Participating Physician party patient payment physi physicians and hospitals potential PPO arrangement PPO development PPO’s practice pre-admission Pre-Operational Nature preferred provider organizations price fixing problems procedures provider-based PPO rates recruitment reimbursement require Review Organization risk segments selection Sherman Act specific sponsored Status strategy structure subscribers success third-party tion Universal Health Network utilization review viders