302F00000X Exclusive Provider Organization
Description
A health insurance organization that provides coverage only when patients use doctors, hospitals, or clinics within a specific network. Patients must choose from the network's approved providers for care and services, except in emergencies. Common services covered include primary care visits, specialist appointments, preventive care, and hospital stays, but care outside the network is usually not covered. Patients can expect coordinated care and lower out-of-pocket costs when using network providers.
- Grouping
- Managed Care Organizations
- Classification
- Exclusive Provider Organization