Question

The patient tells the nurse that she is enrolled in a preferred provider organization but does not understand what this is. What is the nurse's best explanation of preferred provider organization?

a) This health plan provides you with a preferred list of physicians, hospitals, and providers which you can choose from.
b) This health plan is for people who cannot afford their own health insurance
c) This is a fee-for-service plan in which you can choose any physician or hospital
d) This health plan is operated by the government to provide health care to older adults

Answer 1

A PPO is a type of health plan that provides a list of healthcare providers who offer services at reduced rates to members. It offers both a preferred provider network and the flexibility to visit non-network providers at an additional cost.

Step-by-step explanation:

The nurse can explain to the patient that a preferred provider organization (PPO) is a type of health plan that provides a list of physicians, hospitals, and other providers that the PPO has contracted with to provide health care at reduced rates to its members. It is not solely for those who cannot afford health insurance, nor is it a fee-for-service plan where you can choose any physician, nor is it operated by the government. Hence, the best explanation for a patient enrolled in a PPO would be that this health plan gives you access to a select network of healthcare providers and facilities where you can receive services at a lower cost, but you also have the flexibility to see providers outside of the network at a higher cost.