Preferred Provider Organization (PPO)
Preferred Provider Organization (PPO) networks utilize a network of participating medical providers known as preferred or in-network providers who agree to provide services to plan policyholders at reduced rates. Policyholders can see medical providers outside the PPO's network but at a higher cost.
PBA contracts with more than 100 national, regional, and hospital system based networks to maximize provider coverage for plan members while optimizing discounts for plan cost management. In addition, PBA’s partnership with Zelis allows our clients access to multiple PPO networks that can be used for discounting claims outside of the primary network. When a provider is not part of any network, Zelis will attempt to negotiate discounts with the provider.
For each client, we will provide analyses including projected discounts, GEO reports, and provider disruptions to assure that the members and the plan has the most appropriate network configuration.