Difference between HMO and PPO in medical billing [HMO PPO POS]

Hi friends welcome back to my channel today's topic difference between hmo ppo and pos plans hmo stands for health maintenance organization insurance providing affordable policies to patient with low premiums and low out of pocket costs is called hmo plan it will cover only in network provider.

Visit for any specialist visit or in emergency cases required primary care physician referral ppo stands for preferred provider organization insurance providing less restriction policies to patient with high premiums and high.

Out-of-pocket cost is known as ppo plan patient has choice to select pcp no referral required to visit any specialist or in emergency pos stands for point of service it is an intermediate plan between hmo and ppo plans patient has choice to select pcp for any specialist visit or in emergency.

Cases required pcp referral premiums will be higher than hmo plans and lower than ppo let's see the difference among these plans all plans covers in network provider hmo does not cover out of network.

Provider pos covers at high premiums hmo plan does not allow patient to select pcp no referrals are needed to visit any provider in ppo plans with less advantages hmo has low premium cost in pos plans deductibles are applied.

If claims are processed at out of network level in pos plans copay is not applied to out-of-network claims thanks for watching this video have a good day

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