How Health Insurance Works and what are The Three Types of Managed Care Organizations?

Coding Materials
Sep 3, 2018 · 2 min read

Medical Insurance is necessary to protect the cost of Healthcare. As we know medical expenses are skyrocketing as day by day and you never know when the health scare will strike. Thus the Health Insurance helps you to protect the high costs of expenses. Many insurance companies provide you with the variety of health insurance plans with the different level of coverage to fit your needs and budget. Coding materials are providing you with several books that gives information about coding and billing practices. In this, you can pay for services and plans for your treatment. Many people subscribe for companies in order to reduce the impact of medical expenses. Companies will provide more ways to pay for these insurance plans.

Company’s plans have deductibles which are economic limits after which the insurance companies assume the cost of the medical procedure. The doctors, hospitals and pharmacies and human care professionals will sign a contract with these organizations in the health plan network. Let us look at the three types of managed care organizations which will provide you with benefits of Healthcare facilities:-

Health Maintenance Organization (HMO):- This organization provides you with the accidental coverage for a monthly or annual fee. It provides the limit coverage to medical aids provided from doctors that are under the contract from HMO.

HMO is a most popular option for managed care organizations. They allow the subscribers to pay the low premium and a strict network of providers. Like a coin has two sides likewise HMO is cheaper on one hand while it is less flexible on another.

Preferred Provider Organization (PPO): — This organization improves the size of the plan network and ability to see the plan costs and coverage of out of network services. It creates a contract with medical providers such as hospitals to create a network of participating providers. The main advantage of PPO is that it provides flexibility to the people but the disadvantage is that it has a higher premium.

Point of Service (POS):- It is considered as a hybrid of HMO and PPO plans. It is the most popular medical plan in the United States. It is the combination of characteristics of HMO and PPO services. It has the advantage with the lower medical costs in exchange for more limited choice.
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codingmaterials.com is an online platform that serves the health care sectors by providing them sources for top industry coding, billing and reimbursement.

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