The general health care plan that uses a direct contractual relationship between employers,health-care providers and third-party payers is:
A) the traditional coverage plan.
B) an HMO.
C) a PPO.
D) a POS.

Question

Quizplus · Accepted Answer

A PPO (preferred provider organization) is a type of health care plan that involves a direct contractual relationship between employers, health-care providers, and third-party payers. Under a PPO plan, employees are able to choose from a network of preferred providers for their health care services, and these providers agree to charge reduced rates in order to participate in the plan. This type of plan is different from an HMO (health maintenance organization) because it allows employees to seek care outside of the network, albeit at a higher cost. A POS (point of service) plan is similar to a PPO but typically requires employees to choose a primary care physician who acts as a gatekeeper for referrals to specialists. Therefore, the best choice for this question is C) a PPO.

The General Health Care Plan That Uses a Direct Contractual