Questions? We have some helpful answers.
Have you ever wanted to know what PPO Contracts are and really mean to your practice? Physician Partners (The Largest Scripps Affiliated IPA in San Diego County) has delivered an informative FAQ list below for to review you. If you don’t find the information here you’re looking for, please feel free to contact us anytime. We’re here to help.
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We’ve also supplied a complete listing of the 34 Fee-For-Service contracts that Physician Partners offers its members. Please download the list to learn more.
- What is a PPO?
A PPO is a preferred provider organization. Both insurance companies like Aetna and Cigna, and network companies like Beech Street, First Health, Interplan and Multiplan, can be PPOs. PPOs allow patients to select their own physicians, including specialists, within a large network, without requiring them to go through a primary care physician for referrals.
- How many PPO patients are there in San Diego County?
Currently, about 20% of San Diego residents receive health insurance coverage through PPOs.
- How are PPO patients identified?
PPO patients under group health plans carry insurance cards with the PPO network logo, usually displayed in the upper right corner of the front of the card. The PPO network may not be the payor of the Patient’s insurance claims.
- How does a PPO network company work?
A PPO network company, like First Health or Multiplan, sells its network of physicians to clients, who may include Self-Insured Employers, Insurance Companies, Third Party Administrators, or Labor Unions. These PPO clients are usually the claims payers.
- Are PPO networks also offered to workers' compensation insurance companies?
Yes, many workers’ compensation companies access PPO networks to provide medical services to their insured injured workers.
- What is a the reimbursement for physicians under PPO contracts?
Physician Partners PPO contracts are paid at desirable fee-for-service rates.
- How many clients does a typical PPO network company have?
Multiplan has over 800 clients accessing their network, and First Health/Coventry has over 3500 clients.
- Who are some of the Physician Partners PPO network clients?
- 1st Choice
- American Benefits
- Apex Companies
- California Ironworkers Field Welfare Plan
- City of La Mesa
- Guardian Life
- Health Net
- K12 Schools in The State of California
- Mutual of Omaha
- National Association of Letter Carriers
- Plan Handlers
- Principal Life Insurance
- San Diego & Imperial Valley School Districts Fringe Benefits
- San Diego Cement Masons Trust
- San Diego Teamsters
- San Diego State (PIA)
- San Diego HCS 3192 (Health Net Federal Services)
- Sun Life
- Teamsters Benefit Trust
- UC Extension San Diego
- United Healthcare Insurance Company
- Zenith American Solutions