Exclusive Provider Organization (EPO): A healthcare benefit arrangement that is similar to a preferred provider organization in administration, structure, and operation, but which does not cover out-of-network care.

 

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Exclusive Provider Organization (EPO): A healthcare benefit arrangement that is similar to a preferred provider organization in administration, structure, and operation, but which does not cover out-of-network care.

Out-Of-Network Provider: Any health care provider that does not belong to a CIGNA network. Members can use their benefits for out-of-network expenses, but miss out on in-network discounts.

Organizational Unit: An organizational unit is any component that is part of the contractor's corporate structure. In a more traditional organization, it might be a department, division, section, branch or group . . . View Full Definition

Organizational Transformation: Refers to organization-wide changes, such as restructuring operations, introducing new technologies, processes, services or products, implementing new programs, re-engineering, etc.

Participating Provider: A physician, hospital, pharmacy, laboratory or other appropriately licensed facility or provider of health care services or supplies that has entered into an agreement with a managed care en . . . View Full Definition

Peer Review Organizations (Pros): According to the Balanced Budget Act of 1997, organizations or groups of practicing physicians and other healthcare professionals paid by the federal government to review and evaluate the se . . . View Full Definition

Plan Provider: The plan provider of a retirement savings plan, such as a 401(k), 403(b), or 457 plan is the mutual fund company, insurance company, brokerage firm, or other financial services company that . . . View Full Definition

Plan For Reorganization: A plan for reorganizing a firm during the Chapter 11 bankruptcy process.

Physician-Hospital Organization (PHO): A joint venture between a hospital and many or all of its admitting physicians whose primary purpose is contract negotiations with MCOs and marketing.

Organizational Survey: The process of evaluating and analyzing an organization’s structure and other major components to determine whether they are suitably meeting the organization’s current and future needs.