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Preferred Provider Organization (PPO)A program that establishes contracts with medical care providers of - providers referred to as "preferred"• Provides member with better benefits (more coverage) when PPO network providers are used • Higher cost sharing for utilizing out-of-network providers • Can be provided on either a fully or self-insured basis • Providers are typically reimbursed on a fee-for-service basis • BHSG physicians are reimbursed from the BHSG professional fee schedule • BHSG hospitals and other facility providers typically are reimbursed on a discount-off-charges basis |
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