exclusive provider organization


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Related to exclusive provider organization: preferred provider organization

ex·clu·sive pro·vid·er or·gan·i·za·tion (EPO),

(eks-klū'siv prō-vīd'ĕr ōr'gan-i-zā'shŭn),
A managed care plan in which enrollees must receive their care from affiliated providers; treatment provided outside the approved network must be paid for by the patients.
See also: managed care.

Exclusive Provider Organization (EPO)

a type of managed health care organization in which no coverage is typically provided for services received outside the EPO. However, some EPOs incorporate the primary care physician gatekeeper concept along with prospective approval of referrals to specialists of providers outside the EPO.

exclusive provider organization

Managed care A managed care organization similar to a PPO–preferred provider organization in purpose and organization, which allows a Pt to go outside the network for care, but must pay the full cost of the services received; it is similar to an HMO in that primary care physicians act as gatekeepers to a network of other providers, an authorization system, etc. See Gatekeeper, HMO, Managed care organization, PPO.

ex·clu·sive pro·vid·er or·gan·i·za·tion

(EPO) (eks-klū'siv prŏ-vī'dĕr ōr'găn-ī-zā'shŭn)
A managed care plan in the U.S. in which enrollees must receive their care from affiliated providers; treatment provided outside the approved network must be paid for by the patients.
See also: managed care

ex·clu·sive pro·vid·er or·gan·i·za·tion

(EPO) (eks-klū'siv prŏ-vī'dĕr ōr'găn-ī-zā'shŭn)
A managed care plan in the U.S. in which enrollees must receive their care from affiliated providers; treatment provided outside the approved network must be paid for by the patients.
See also: managed care

exclusive provider organization (EPO),

n a dental benefits plan that provides benefits only if care is rendered by institutional and professional providers with whom the plan contracts (with some exceptions for emergency and out-of-area services).
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References in periodicals archive ?
We are pleased to have added the 94,500 SCHIP Exclusive Provider Organization members in Texas, effective September 1, 2004, ahead of schedule.
In some cases, hospitals are combining with insurance companies to form exclusive provider organizations (EPOs) that limit choice to a small panel of physicians in an effort to maximize profits by controlling the care they provide.
HMOs, exclusive provider organizations, and preferred provider organizations are mostly funnels for money between customers and suppliers.