Practice Quiz

Managed Care Nursing

Category - Overview

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Which of the following statement accurately reflects the description of the PPO model of an MCO?
  1. Members can select in or outside of provider network without special referrals. There may be higher copayment when out of network.
  2. Members have a wide choice of providers and locations with a set percentage to pay for service.
  3. The member pays the cost of service after service is provided (a fee-for-service plan type).
  4. B and C
  5. None of the above
Explanation
Answer: A - When a member can select in or outside of provider network without special referrals and often pay higher copayments when out of network is a description of the PPO model of an MCO.

There may be higher copayments when out of network.
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