HMO stands for Health Maintenance Organization. The HMO provides or arranges for the health plans of company employees. The HMO pays for the cost of specific medical services that are needed by the employees. These medical services include doctors' visits, emergency room visits, medical services from specialists, and hospitalization. HMO health plans usually operate on the concept of preventative care. They cover your healthcare needs, while you're still generally healthy, to prevent you from getting sick or acquiring serious illnesses. Most HMOs offer health plans that provide comprehensive coverage for their members at reasonable prices. However, health plans, offered through HMOs, might have certain limitations. You may have limited choices of primary care physicians, for eample. You might also encounter difficulties when seeking the approval of referrals to specialists in case you suffer from serious diseases or illnesses. IPO stands for Independent Provider Organization. The IPO works with an HMO. The HMO contracts the services of independent physicians. These independent physicians are paid to provide medical services to the members of the HMO as part of the provisions for their health plans. PPO stands for Preferred Provider Organization. A PPO contracts healthcare providers to provide medical services to their members at pre-arranged costs. The members can only use the benefits of their health plans by getting the services of the doctors and specialists that belong in the PPO's network of healthcare providers, including hospitals. If the member uses the services of the healthcare providers that do not belong in the PPO's network, then the member pays for the healthcare services from his own pocket. PRO stands for Peer Review Organization. This is used by the HMO so that its members are assured of receiving quality healthcare services through their health plans. The PRO makes sure that the healthcare services delivered meet professional standards. The PRO accommodates and resolves complaints and grievances on the level of service provided by the HMO. POS stands for Point of Service. POS health plans allow the policy holder to use the medical services of doctors and specialists that do not belong in the POS network of healthcare providers. However, the policyholder may be restricted in terms of heath benefits, and likely pays more out-of-pocket cost. Answer by admin — May 25, 2009 @ 12:12 am