Exclusive Provider Organization (epo)
Definition of "Exclusive provider organization (epo)"
Organization that is part of a preferred provider organization (PPO) in which enrollees select an EPO provider to act as their primary care physician and serve as the gatekeeper. This gatekeeper approves the maximum level of benefits to which the enrollee is entitled. Characteristics of the EPO include emphasis placed on quality of care, utilization of the primary physician, and specified financial structure with the providers on a fee-for-service basis.
Popular Insurance Terms
Section of the "Unfair Trade Practices Code" of most states that declares the use of coercion to be in violation of the state code. ...
Day-to-day care that a patient (generally older than 65) receives in a nursing facility or in his or her residence following an illness or injury, or in old age, such that the patient can ...
Reinsurance term under which the reinsurer exercises its faculty or prerogative to insure a risk or reject a risk from a ceding company. ...
Element of a life insurance policy permitting the policy owner to change a beneficiary as frequently as desired unless the beneficiary has been designated as irrevocable. Here the written ...
Separate legal entity formed by one or more physicians and one or more hospitals whose objective it is to negotiate contracts with payer organizations. The PHO provides financial, ...
Time period, for a life insurance policy, in which losses occur. This period must be determined to project the frequency and severity of future loss experience. ...
Total of the insurance company's mortgages whose interest has not been paid for at least three months. These are mortgages upon which the insurance company is in the process of foreclosing, ...
Insured's income prior to the disability minus the insured's income after the disability. ...
Coverage of an employee group whose members receive a monthly disability income benefit, subject to a maximum amount, if illness or accident prevents a member from performing the normal ...
Have a question or comment?
We're here to help.