PPO New York

A preferred provider organization (PPO) is a specific type of health insurance dictated by a flexible network of medical providers for a participant. Employees and individuals looking into PPO as a form of managed care need to understand this form of insurance from the perspectives of doctors, insurers and consumers. Healthcare in the United States is becoming more and more costly and health insurance is very necessary for every United States citizen.


1 . Local Companies

Sid Mukherjee
1633 Broadway
New York, NY
Stephen Jenkins
18 Division Street
Saratoga Springs, NY
Anthony Shark
29 adrian avenue suite D-6
bronx, NY
William Martone
50 Main Street
White Plains, NY
Lee Cameron
315 Madison Avenue
New York, NY
Helen Beichel
1133 Park Place
Brooklyn, NY
Donald Conrad
1377 Motor Parkway
Islandia, NY
Jeffrey Lewis, CFP, ChFC
7 White Deer Court
Huntington, NY
Matthew Berman
1393 Veterans Memorial Highway
Hauppauge, NY
Jared Cutler
611 Pondside Drive
White Plains, NY
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2 . Widening the Medical Network with a PPO

The essence of the trend toward PPOs instead of health management organizations (HMO) is a concern over the flexibility of health care. Workers who switched jobs, moved across country and dealt with alternating economic statuses were unable to maintain steady coverage from the same insurer. PPO insurers have countered the inflexibility of a traditional HMO by negotiating discounted billing rates with hospitals, clinics and health care providers in all 50 states. The result of these negotiations has been a wide network of providers available to a PPO holder who is traveling or moving frequently for work.

PPO networks can take a variety of shapes depending on the unique health care environment of a particular region. Insured professionals in the Northeast and Southwest can use the flexible resources of a PPO insurer to take advantage of neighborhood clinics instead of massive emergency rooms for preventive care. Individuals in rural areas can access health care through a small doctor's office that is part of a preferred provider organization.
The majority of services provided through a PPO come from the largest health care providers in the United States. Massive health care organizations work with insurers to develop extensive fee schedules to ensure that individuals within a prescribed network are receiving the right benefits. An insurer with a nationwide reach provides access through a PPO to thousands of hospitals for busy professionals on the move.

3 . Use of Specialists in a PPO

An insurance applicant using a traditional HMO needs to declare a primary care physician before they receive care. Insurance companies offering an older style of health care want to know the primary care physician as a way to create an accurate premium. One of the major benefits for PPO participants is the lack of a primary care physician requirement on application materials. The flexibility of PPOs means that a professional can see any physician within the established network of providers without consulting a primary physician.

The reason why a primary care physician is an obstacle in other forms of health care is the necessity for referrals in order to get covered services. Insured professionals in this scenario need to get notification from their doctor that specialized services from therapists, podiatrists and others are necessary for current medical issues. A PPO participant can bypass this cumbersome process by finding a hospital or clinic with a specialist covered by the insurance policy. Health insurance companies pre-negotiate the specialists who are available to consumers based on pre-existing conditions and the complicated calculus of discounts created at the beginning of the PPO arrangement.

4 . Benefits of PPO to Providers and Insurance Companies

Consumers need to know why a PPO is beneficial to their insurance companies and health care providers to make an informed decision. The doctors and hospitals that form a preferred provider organization get the benefit of increased use of their services. An insurance holder participating in a PPO feels comfortable heading into the doctor's office for preventative care as well as emergency care. The discounts available on prescriptions, checkups and surgeries may decrease a hospital's revenue with one patient but increases revenue through optional services for a thousand patients.

The benefits of the PPO are not exclusive to the health care provider. Insurance companies created the PPO concept several decades ago to cut down on the costs to patients while maintaining a significant percentage of health care revenue. Insurance companies meet with the board of directors and clinic directors to run through discounts offered on services ranging from a simple checkup to a multi-stage surgery. While the clinics involved get a large chunk of the revenue to take care of overhead costs, insurance companies receive a percentage of each covered procedure to continue providing services to insurance holders. The benefit of increased traffic works for insurance companies as well as health care providers with the looming baby boomer generation creating a bonanza for preferred provider organizations.
Regional Articles
- PPO Albany NY
- PPO Amityville NY
- PPO Amsterdam NY
- PPO Arverne NY
- PPO Astoria NY
- PPO Auburn NY
- PPO Babylon NY
- PPO Baldwin NY
- PPO Baldwinsville NY
- PPO Ballston Spa NY
- PPO Bay Shore NY
- PPO Bayside NY
- PPO Beacon NY
- PPO Bellerose NY
- PPO Bellmore NY
- PPO Bethpage NY
- PPO Binghamton NY
- PPO Brentwood NY
- PPO Brewster NY
- PPO Brockport NY
- PPO Bronx NY
- PPO Bronxville NY
- PPO Brooklyn NY
- PPO Buffalo NY
- PPO Cambria Heights NY
- PPO Camillus NY
- PPO Canandaigua NY
- PPO Centereach NY
- PPO Central Islip NY
- PPO Clifton Park NY
- PPO Cohoes NY
- PPO College Point NY
- PPO Commack NY
- PPO Copiague NY
- PPO Coram NY
- PPO Corning NY
- PPO Corona NY
- PPO Cortland NY
- PPO Cortlandt Manor NY
- PPO Deer Park NY
- PPO Delmar NY
- PPO Depew NY
- PPO Dunkirk NY
- PPO East Amherst NY
- PPO East Aurora NY
- PPO East Elmhurst NY
- PPO East Islip NY
- PPO East Meadow NY
- PPO East Northport NY
- PPO East Setauket NY
- PPO East Syracuse NY
- PPO Elmhurst NY
- PPO Elmira NY
- PPO Elmont NY
- PPO Endicott NY
- PPO Fairport NY
- PPO Far Rockaway NY
- PPO Farmingdale NY
- PPO Farmingville NY
- PPO Floral Park NY
- PPO Flushing NY
- PPO Forest Hills NY
- PPO Franklin Square NY
- PPO Fredonia NY
- PPO Freeport NY
- PPO Fresh Meadows NY
- PPO Fulton NY
- PPO Garden City NY
- PPO Glen Cove NY
- PPO Glen Oaks NY
- PPO Glens Falls NY
- PPO Gloversville NY
- PPO Great Neck NY
- PPO Hamburg NY
- PPO Hauppauge NY
- PPO Hempstead NY
- PPO Hicksville NY
- PPO Hilton NY
- PPO Holbrook NY
- PPO Hollis NY
- PPO Hopewell Junction NY
- PPO Horseheads NY
- PPO Howard Beach NY
- PPO Huntington NY
- PPO Huntington Station NY
- PPO Islip NY
- PPO Ithaca NY
- PPO Jackson Heights NY
- PPO Jamaica NY
- PPO Jamestown NY
- PPO Kew Gardens NY
- PPO Kings Park NY
- PPO Kingston NY
- PPO Lancaster NY
- PPO Larchmont NY
- PPO Latham NY
- PPO Levittown NY
- PPO Lindenhurst NY
- PPO Little Neck NY
- PPO Liverpool NY
- PPO Lockport NY
- PPO Long Beach NY
- PPO Long Island City NY
- PPO Lynbrook NY
- PPO Mahopac NY
- PPO Malone NY
- PPO Mamaroneck NY
- PPO Manhasset NY
- PPO Manlius NY
- PPO Maspeth NY
- PPO Massapequa NY
- PPO Massapequa Park NY
- PPO Massena NY
- PPO Mastic NY
- PPO Melville NY
- PPO Merrick NY
- PPO Middle Village NY
- PPO Middletown NY
- PPO Mineola NY
- PPO Monroe NY
- PPO Monsey NY
- PPO Mount Kisco NY
- PPO Mount Vernon NY
- PPO Nanuet NY
- PPO New City NY
- PPO New Hartford NY
- PPO New Hyde Park NY
- PPO New Paltz NY
- PPO New Rochelle NY
- PPO New Windsor NY
- PPO New York NY
- PPO Newburgh NY
- PPO Niagara Falls NY
- PPO North Babylon NY
- PPO North Tonawanda NY
- PPO Nyack NY
- PPO Oakland Gardens NY
- PPO Oceanside NY
- PPO Ogdensburg NY
- PPO Olean NY
- PPO Oneonta NY
- PPO Orchard Park NY
- PPO Ossining NY
- PPO Oswego NY
- PPO Ozone Park NY
- PPO Patchogue NY
- PPO Pearl River NY
- PPO Peekskill NY
- PPO Penfield NY
- PPO Pittsford NY
- PPO Plainview NY
- PPO Plattsburgh NY
- PPO Port Chester NY
- PPO Port Jefferson Station NY
- PPO Port Washington NY
- PPO Potsdam NY
- PPO Poughkeepsie NY
- PPO Queens Village NY
- PPO Queensbury NY
- PPO Rego Park NY
- PPO Rensselaer NY
- PPO Richmond Hill NY
- PPO Ridgewood NY
- PPO Riverhead NY
- PPO Rochester NY
- PPO Rockaway Park NY
- PPO Rockville Centre NY
- PPO Rome NY
- PPO Ronkonkoma NY
- PPO Roosevelt NY
- PPO Rosedale NY
- PPO Rye NY
- PPO Saint Albans NY
- PPO Saint James NY
- PPO Saratoga Springs NY
- PPO Saugerties NY
- PPO Sayville NY
- PPO Scarsdale NY
- PPO Schenectady NY
- PPO Selden NY
- PPO Shirley NY
- PPO Smithtown NY
- PPO South Ozone Park NY
- PPO South Richmond Hill NY
- PPO Spencerport NY
- PPO Spring Valley NY
- PPO Springfield Gardens NY
- PPO Staten Island NY
- PPO Stony Brook NY
- PPO Suffern NY
- PPO Sunnyside NY
- PPO Syosset NY
- PPO Syracuse NY
- PPO Tarrytown NY
- PPO Tonawanda NY
- PPO Troy NY
- PPO Uniondale NY
- PPO Utica NY
- PPO Valley Stream NY
- PPO Vestal NY
- PPO Wantagh NY
- PPO Wappingers Falls NY
- PPO Watertown NY
- PPO Watervliet NY
- PPO Webster NY
- PPO West Babylon NY
- PPO West Hempstead NY
- PPO West Islip NY
- PPO Westbury NY
- PPO White Plains NY
- PPO Whitestone NY
- PPO Woodhaven NY
- PPO Woodside NY
- PPO Wyandanch NY
- PPO Yonkers NY
- PPO Yorktown Heights NY
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