SlideShare a Scribd company logo
1 of 7
Download to read offline
Tell Me About… POS
POINT OF SERVICE (POS) HEALTH INSURANCE PLANS
It’s a combo…
Combination
POS plans combine
features of an HMO and a
PPO plan.
Requirements
✓ POS plans may require
employees to choose a
Primary Care Physician
(PCP) from the plan's
network providers.
Services
Services rendered by
the PCP aren't subject
to the policy's
deductible.
Utilizing Covered
Services…
IF EMPLOYEES UTILIZE
COVERED SERVICES THAT
ARE RENDERED OR REFERRED
BY THEIR PCP, THEY MAY
RECEIVE THE HIGHER LEVEL
OF COVERAGE.
Non-Network Providers
 If you utilize services by a non-network provider,
you may be subject to a deductible and lower
level of coverage.
 You may also have to pay up-front and submit
a claim for reimbursement.
What you’ll get…
Freedom
A moderate amount of
freedom to choose
your health care
providers -- more than
an HMO; you do not
have to get a referral
from a primary care
doctor to see a
specialist.
Higher Costs
What doctors you can
see? Any in the PPO's
network; you can see
out-of-network doctors,
but you'll pay more out-
of-pocket doctors vs. in-
network providers.
More Paperwork
More paperwork than
with other plans if you
see out-of-network
providers
A POS may be a
good option for
small business if
your employees:
✓ NEED FLEXIBILITY WHEN
CHOOSING PHYSICIANS
AND OTHER PROVIDERS
✓ DESIRE PRIMARY CARE
PHYSICIANS TO
COORDINATE CARE
✓ LIKE THE BALANCE OF
GREATER PROVIDER
CHOICE VERSUS LOWER
PREMIUMS
Ask me a question…
Message me: LinkedIn
Email me: acarrier@FinancialAndBenefitServices.com
Call me: 724-941-8772 (cell)

More Related Content

What's hot

EHR Ep Decision Tool
EHR Ep Decision ToolEHR Ep Decision Tool
EHR Ep Decision Tool
Mindy Altiero
 
Regulation 101 for providers who bill govt funded plans
Regulation 101 for providers who bill govt funded plansRegulation 101 for providers who bill govt funded plans
Regulation 101 for providers who bill govt funded plans
Christy Stafford
 
Jd Revised Undestanding Insurance Eliigibilityprocess Iii
Jd Revised Undestanding Insurance Eliigibilityprocess IiiJd Revised Undestanding Insurance Eliigibilityprocess Iii
Jd Revised Undestanding Insurance Eliigibilityprocess Iii
jdesir8472
 
Tricare echo ppt brief from efmp training conference
Tricare echo ppt brief from efmp training conferenceTricare echo ppt brief from efmp training conference
Tricare echo ppt brief from efmp training conference
NavyEFMP
 
Aflac Presentation
Aflac PresentationAflac Presentation
Aflac Presentation
aflac
 
Medical Billing Simple Manual
Medical Billing Simple ManualMedical Billing Simple Manual
Medical Billing Simple Manual
Karna *
 

What's hot (20)

EHR Ep Decision Tool
EHR Ep Decision ToolEHR Ep Decision Tool
EHR Ep Decision Tool
 
Regulation 101 for providers who bill govt funded plans
Regulation 101 for providers who bill govt funded plansRegulation 101 for providers who bill govt funded plans
Regulation 101 for providers who bill govt funded plans
 
Don't give up on affordable healthcare yet..
Don't give up on affordable healthcare yet..Don't give up on affordable healthcare yet..
Don't give up on affordable healthcare yet..
 
Jd Revised Undestanding Insurance Eliigibilityprocess Iii
Jd Revised Undestanding Insurance Eliigibilityprocess IiiJd Revised Undestanding Insurance Eliigibilityprocess Iii
Jd Revised Undestanding Insurance Eliigibilityprocess Iii
 
Louisiana medical psychologists telemedicine overview - the who, what, when, ...
Louisiana medical psychologists telemedicine overview - the who, what, when, ...Louisiana medical psychologists telemedicine overview - the who, what, when, ...
Louisiana medical psychologists telemedicine overview - the who, what, when, ...
 
Tricare echo ppt brief from efmp training conference
Tricare echo ppt brief from efmp training conferenceTricare echo ppt brief from efmp training conference
Tricare echo ppt brief from efmp training conference
 
Aflac Presentation
Aflac PresentationAflac Presentation
Aflac Presentation
 
Surgical assistant overview
Surgical assistant overviewSurgical assistant overview
Surgical assistant overview
 
Billing and Reimbursement for Surgical Assistants - How to start
Billing and Reimbursement for Surgical Assistants - How to startBilling and Reimbursement for Surgical Assistants - How to start
Billing and Reimbursement for Surgical Assistants - How to start
 
Understanding health insurance reimbursement for Surgical Assistants
Understanding health insurance reimbursement for Surgical AssistantsUnderstanding health insurance reimbursement for Surgical Assistants
Understanding health insurance reimbursement for Surgical Assistants
 
Health insurance of different companies
 Health insurance of different companies  Health insurance of different companies
Health insurance of different companies
 
Out of Network overview for Surgical Assistants
Out of Network overview for Surgical AssistantsOut of Network overview for Surgical Assistants
Out of Network overview for Surgical Assistants
 
NSAA 2014 conference
NSAA 2014 conferenceNSAA 2014 conference
NSAA 2014 conference
 
Surgical Assistant Cost-Benefit Analysis
Surgical Assistant Cost-Benefit AnalysisSurgical Assistant Cost-Benefit Analysis
Surgical Assistant Cost-Benefit Analysis
 
Medical Billing Simple Manual
Medical Billing Simple ManualMedical Billing Simple Manual
Medical Billing Simple Manual
 
Health Insurance Glossary
Health Insurance GlossaryHealth Insurance Glossary
Health Insurance Glossary
 
medical billing training notes
medical billing training notesmedical billing training notes
medical billing training notes
 
UCR
UCRUCR
UCR
 
Rnfa medical billing
Rnfa  medical billingRnfa  medical billing
Rnfa medical billing
 
Harmony demo 3-14-13
Harmony demo  3-14-13Harmony demo  3-14-13
Harmony demo 3-14-13
 

Similar to What is Point of Service Health Insurance Coverage?

Documents.asp
Documents.aspDocuments.asp
Documents.asp
wsroth
 
Documents.asp
Documents.aspDocuments.asp
Documents.asp
wsroth
 
This guide will help you understand the questions you should a.docx
This guide will help you understand the questions you should a.docxThis guide will help you understand the questions you should a.docx
This guide will help you understand the questions you should a.docx
jwilliam16
 
A pos managed care plan can be a(finished)
A pos managed care plan can be a(finished)A pos managed care plan can be a(finished)
A pos managed care plan can be a(finished)
RandyBett
 
Bayzat Benefits Brochure (1)
Bayzat Benefits Brochure (1)Bayzat Benefits Brochure (1)
Bayzat Benefits Brochure (1)
Mohamed Althis
 
12M A N A G E M E N T A C C O U N T I N G Q U A R T E R L Y
12M A N A G E M E N T  A C C O U N T I N G  Q U A R T E R L Y 12M A N A G E M E N T  A C C O U N T I N G  Q U A R T E R L Y
12M A N A G E M E N T A C C O U N T I N G Q U A R T E R L Y
EttaBenton28
 
12M A N A G E M E N T A C C O U N T I N G Q U A R T E R L Y
12M A N A G E M E N T  A C C O U N T I N G  Q U A R T E R L Y 12M A N A G E M E N T  A C C O U N T I N G  Q U A R T E R L Y
12M A N A G E M E N T A C C O U N T I N G Q U A R T E R L Y
ChantellPantoja184
 
HLU Presentation.Email.Secure
HLU Presentation.Email.SecureHLU Presentation.Email.Secure
HLU Presentation.Email.Secure
Tad Krafft, CEBS
 

Similar to What is Point of Service Health Insurance Coverage? (20)

Point of Service Healthcare Plan
Point of Service Healthcare PlanPoint of Service Healthcare Plan
Point of Service Healthcare Plan
 
Health and Mediclaim policies
Health and Mediclaim policiesHealth and Mediclaim policies
Health and Mediclaim policies
 
Why You Need Health Insurance: - HealthCompare
Why You Need Health Insurance: - HealthCompareWhy You Need Health Insurance: - HealthCompare
Why You Need Health Insurance: - HealthCompare
 
Documents.asp
Documents.aspDocuments.asp
Documents.asp
 
Documents.asp
Documents.aspDocuments.asp
Documents.asp
 
HMOs and PPOs in USA (Healthcare Management Functions)
HMOs and PPOs in USA (Healthcare Management Functions)HMOs and PPOs in USA (Healthcare Management Functions)
HMOs and PPOs in USA (Healthcare Management Functions)
 
This guide will help you understand the questions you should a.docx
This guide will help you understand the questions you should a.docxThis guide will help you understand the questions you should a.docx
This guide will help you understand the questions you should a.docx
 
Health Insurance Plans.pdf
Health Insurance Plans.pdfHealth Insurance Plans.pdf
Health Insurance Plans.pdf
 
Heatlh Insurance Overview
Heatlh Insurance OverviewHeatlh Insurance Overview
Heatlh Insurance Overview
 
A pos managed care plan can be a(finished)
A pos managed care plan can be a(finished)A pos managed care plan can be a(finished)
A pos managed care plan can be a(finished)
 
JPFarleyppocontract_provision&yourplan
JPFarleyppocontract_provision&yourplanJPFarleyppocontract_provision&yourplan
JPFarleyppocontract_provision&yourplan
 
health insurance.pdf
health insurance.pdfhealth insurance.pdf
health insurance.pdf
 
Sample Employer Health Plan Proposal
Sample Employer Health Plan ProposalSample Employer Health Plan Proposal
Sample Employer Health Plan Proposal
 
Bayzat Benefits Brochure (1)
Bayzat Benefits Brochure (1)Bayzat Benefits Brochure (1)
Bayzat Benefits Brochure (1)
 
12M A N A G E M E N T A C C O U N T I N G Q U A R T E R L Y
12M A N A G E M E N T  A C C O U N T I N G  Q U A R T E R L Y 12M A N A G E M E N T  A C C O U N T I N G  Q U A R T E R L Y
12M A N A G E M E N T A C C O U N T I N G Q U A R T E R L Y
 
12M A N A G E M E N T A C C O U N T I N G Q U A R T E R L Y
12M A N A G E M E N T  A C C O U N T I N G  Q U A R T E R L Y 12M A N A G E M E N T  A C C O U N T I N G  Q U A R T E R L Y
12M A N A G E M E N T A C C O U N T I N G Q U A R T E R L Y
 
AVOIDING & ELIMINATING NON-CONTRACTED DISCOUNTS/SILENT PPOs
AVOIDING & ELIMINATING NON-CONTRACTED DISCOUNTS/SILENT PPOsAVOIDING & ELIMINATING NON-CONTRACTED DISCOUNTS/SILENT PPOs
AVOIDING & ELIMINATING NON-CONTRACTED DISCOUNTS/SILENT PPOs
 
HLU Presentation.Email.Secure
HLU Presentation.Email.SecureHLU Presentation.Email.Secure
HLU Presentation.Email.Secure
 
Overview of an Open-Platform Health Plan that Lowers Costs and Improves Perfo...
Overview of an Open-Platform Health Plan that Lowers Costs and Improves Perfo...Overview of an Open-Platform Health Plan that Lowers Costs and Improves Perfo...
Overview of an Open-Platform Health Plan that Lowers Costs and Improves Perfo...
 
HEALTH INSURANCE PRESENTATION
HEALTH INSURANCE PRESENTATIONHEALTH INSURANCE PRESENTATION
HEALTH INSURANCE PRESENTATION
 

Recently uploaded

Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia
Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi ArabiaCytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia
Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia
jaanualu31
 
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdfTortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
Dr. Afreen Nasir
 
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di CilacapJual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
aureliamarcelin589
 
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
Levi Shapiro
 
ITM HOSPITAL The hospital has also been recognised as the best emerging hosp...
ITM  HOSPITAL The hospital has also been recognised as the best emerging hosp...ITM  HOSPITAL The hospital has also been recognised as the best emerging hosp...
ITM HOSPITAL The hospital has also been recognised as the best emerging hosp...
jvomprakash
 
Spauldings classification ppt by Dr C P PRINCE
Spauldings classification ppt by Dr C P PRINCESpauldings classification ppt by Dr C P PRINCE
Spauldings classification ppt by Dr C P PRINCE
DR.PRINCE C P
 
Abortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAE
Abortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAEAbortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAE
Abortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAE
Abortion pills in Kuwait Cytotec pills in Kuwait
 

Recently uploaded (20)

VIP ℂall Girls Delhi 9873777170 WhatsApp: Me All Time Serviℂe Available Day a...
VIP ℂall Girls Delhi 9873777170 WhatsApp: Me All Time Serviℂe Available Day a...VIP ℂall Girls Delhi 9873777170 WhatsApp: Me All Time Serviℂe Available Day a...
VIP ℂall Girls Delhi 9873777170 WhatsApp: Me All Time Serviℂe Available Day a...
 
An overview of Muir Wood Adolescent and Family Services teen treatment progra...
An overview of Muir Wood Adolescent and Family Services teen treatment progra...An overview of Muir Wood Adolescent and Family Services teen treatment progra...
An overview of Muir Wood Adolescent and Family Services teen treatment progra...
 
Pulse Check Decisions - RRT and Code Blue Workshop
Pulse Check Decisions - RRT and Code Blue WorkshopPulse Check Decisions - RRT and Code Blue Workshop
Pulse Check Decisions - RRT and Code Blue Workshop
 
Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx
Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptxAntiepileptic-Drugs-and-Congenital-Anomalies copy.pptx
Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx
 
Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia
Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi ArabiaCytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia
Cytotec 200mcg tab in Riyadh (+919101817206// Get Abortion Pills in Saudi Arabia
 
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdfTortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
 
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di CilacapJual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
 
Famous Indian Vedic Astrologer | Best Astrological Solutions UK
Famous Indian Vedic Astrologer | Best Astrological Solutions UKFamous Indian Vedic Astrologer | Best Astrological Solutions UK
Famous Indian Vedic Astrologer | Best Astrological Solutions UK
 
Technology transfer documentation and strategies
Technology transfer documentation and strategiesTechnology transfer documentation and strategies
Technology transfer documentation and strategies
 
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
 
Session-3-Promoting-Breastfeeding-During-Pregnancy.ppt
Session-3-Promoting-Breastfeeding-During-Pregnancy.pptSession-3-Promoting-Breastfeeding-During-Pregnancy.ppt
Session-3-Promoting-Breastfeeding-During-Pregnancy.ppt
 
Session-17-KANGAROO-MOTHER-CARE_final-blue.pptx
Session-17-KANGAROO-MOTHER-CARE_final-blue.pptxSession-17-KANGAROO-MOTHER-CARE_final-blue.pptx
Session-17-KANGAROO-MOTHER-CARE_final-blue.pptx
 
ITM HOSPITAL The hospital has also been recognised as the best emerging hosp...
ITM  HOSPITAL The hospital has also been recognised as the best emerging hosp...ITM  HOSPITAL The hospital has also been recognised as the best emerging hosp...
ITM HOSPITAL The hospital has also been recognised as the best emerging hosp...
 
Personnel and Equipment - Code and Rapid Response Workshop
Personnel and Equipment - Code and Rapid Response WorkshopPersonnel and Equipment - Code and Rapid Response Workshop
Personnel and Equipment - Code and Rapid Response Workshop
 
Spauldings classification ppt by Dr C P PRINCE
Spauldings classification ppt by Dr C P PRINCESpauldings classification ppt by Dr C P PRINCE
Spauldings classification ppt by Dr C P PRINCE
 
Anthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirts
Anthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirts
Anthony Edwards We Want Dallas T-shirtsAnthony Edwards We Want Dallas T-shirts
 
End of Response issues - Code and Rapid Response Workshop
End of Response issues - Code and Rapid Response WorkshopEnd of Response issues - Code and Rapid Response Workshop
End of Response issues - Code and Rapid Response Workshop
 
Abortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAE
Abortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAEAbortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAE
Abortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAE
 
Organisation and Management of Eye Care Programme Service Delivery Models
Organisation and Management of Eye Care Programme Service Delivery ModelsOrganisation and Management of Eye Care Programme Service Delivery Models
Organisation and Management of Eye Care Programme Service Delivery Models
 
Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto
Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In SowetoTop^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto
Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto
 

What is Point of Service Health Insurance Coverage?

  • 1. Tell Me About… POS POINT OF SERVICE (POS) HEALTH INSURANCE PLANS
  • 2. It’s a combo… Combination POS plans combine features of an HMO and a PPO plan. Requirements ✓ POS plans may require employees to choose a Primary Care Physician (PCP) from the plan's network providers. Services Services rendered by the PCP aren't subject to the policy's deductible.
  • 3. Utilizing Covered Services… IF EMPLOYEES UTILIZE COVERED SERVICES THAT ARE RENDERED OR REFERRED BY THEIR PCP, THEY MAY RECEIVE THE HIGHER LEVEL OF COVERAGE.
  • 4. Non-Network Providers  If you utilize services by a non-network provider, you may be subject to a deductible and lower level of coverage.  You may also have to pay up-front and submit a claim for reimbursement.
  • 5. What you’ll get… Freedom A moderate amount of freedom to choose your health care providers -- more than an HMO; you do not have to get a referral from a primary care doctor to see a specialist. Higher Costs What doctors you can see? Any in the PPO's network; you can see out-of-network doctors, but you'll pay more out- of-pocket doctors vs. in- network providers. More Paperwork More paperwork than with other plans if you see out-of-network providers
  • 6. A POS may be a good option for small business if your employees: ✓ NEED FLEXIBILITY WHEN CHOOSING PHYSICIANS AND OTHER PROVIDERS ✓ DESIRE PRIMARY CARE PHYSICIANS TO COORDINATE CARE ✓ LIKE THE BALANCE OF GREATER PROVIDER CHOICE VERSUS LOWER PREMIUMS
  • 7. Ask me a question… Message me: LinkedIn Email me: acarrier@FinancialAndBenefitServices.com Call me: 724-941-8772 (cell)