23 Jan 2018

What is MultiPlan PPO?

What is MultiPlan PPO?

When you enroll in a health insurance plan, you are usually given a specific network of doctors that contract with the insurance company, often with outlined specific rates and limits. There are different levels of this provision. One of these options is a PPO, otherwise known as a Preferred Provider Organization.

MultiPlan PPO is not health insurance. However, it is an important part of the health insurance process. Insurance companies will contract with MultiPlan PPO who contract with the doctors in the network. Look at them as the middleman between the insurance company and the doctor’s office or medical facility. PPO’s have certain advantages over the other levels of provision, such as an HMO, that benefit the insured.

What MultiPlan PPO Offers

There are three big differences between what an HMO offers and what PPOs like MultiPlan offer. These include:

Choice of Doctors -With an HMO, you must choose a Primary Care Physician, a specific doctor that will coordinate all your medical care. He must be within the specific network provided by the insurance company, if not you will have to pay out of pocket for the services rendered. With a PPO, you do not have to select a specific doctor; you are able to see any one of the doctors in or out of network, although you do save money if they are within the specific network.

Another difference is the coordination of benefits. With an HMO, you must first get a referral from your Primary Care Physician before you see a specialist for any reason.

Negotiated Savings -This is the main purpose of PPO Networks. To work out the fine details of costs between the insurance company and the doctors. This can mean savings for you in the long run as long as you stay within the network. You are free to see any doctor, but the contracted rates are with the providers within the network.

Quality of Service Providers -MultiPlan PPO has rigorous criteria when they are evaluating the providers for their network. You can rest assured that the doctors they contract with are of the highest quality.

How to Receive MultiPlan PPO Services

Remember, MultiPlan PPO is not insurance, nor do they sell insurance. You can receive their services by having an insurance company that contracts through them. HMOs are the same in this instance; both are the middleman between the insurance companies and the doctors in their network.

How to Use MultiPlan PPO Services

Once you have an insurance policy that uses MultiPlan PPO, you can contact them to help you find the doctor you would like to use or to find the doctor you are currently using. You can reach them through:

  • Their website. You simply follow the prompts on screen to enter your search criteria
  • The phone number on your insurance card. During business hours they can assist you in finding the medical provider you need.

Keep in mind that it is your responsibility to confirm that the doctor you are using is on the network. Never assume. Again, you can use any doctor you choose with MultiPlan PPO, but your greatest savings will be when you use a doctor within the network.

In most cases, you will not have to worry about filing any claims with your insurance company for the services you receive. This can change if you choose to see an out of network doctor. In those cases, you may have to pay the doctor directly, then file a reimbursement claim with the insurance company. Another reason why it is beneficial to remain within the network.

If you have a regular doctor that you see, and they are not in the network, you can nominate them for consideration with MultiPlan PPO. Once the nomination is received, your doctor will be contacted and asked if they would care to join the network, if interested they will go through the screening process they are known for. After approval, you will receive the benefits of having your doctor in your network.

To learn more about MultiPlan PPO or additional insurance options, contact the experts at HealthQuoteInfo.com at 855-614-5057. Our licensed health insurance experts will be happy to answer any questions you have.

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