An HMO is a Health Maintenance Organization. They provide services which include health insurance, self-funded health care benefit plans and provides communication between health care providers and individuals.
An HMO is a construct intended to combine the financing and the delivery of health care services. It provides a comprehensive set of health care services to members (subscribers) in return for a monthly fee. Stated otherwise, an HMO may be considered to be both a health care provider and an insurer.
Difference between HMO (Health Maintenance Organization) and MCO (Managed Care Organization) is that in HMO where the insurance creates an network of providers termed PCPs (Primary Care Physicians), but in the case of MCO the health care provider or group of medical service provider who contract with insurers or self-insured employers to provide the wide variety of managed helath care services.
According to the text book "Medical Billing and Insurance Coding"-Fordney and French.... "The prepaid group practice model delivers services at one more locations thru a group of physicians who either 1.contract thru the HMO to provide care or 2. are employed aby the HMO........."
The HMO Blue Cross plan covers inpatient and outpatient medical care, mental health care, substance use care, prescription drug coverage, and preventative care.
Health Maintenance Organization HMO stands for Health Maintance Organization. Basically an HMO lets you go to a small group of doctors and hospitals. But, if you go anywhere else you have NO COVERAGE.
A prepaid group practice serving a specific geographic area helth care
In order for an organization to qualify as an HMO, it must have an organized system for providing health care in a geographic area, basic supplemental health maintenance and treatment services must be set up and agreed upon and the organization must be a voluntarily enrolled group of people.
Health Maintenance Organization (also called an HMO) is one of three managed care health insurance systems in the United States. An HMO is designed to offer financial support and medical treatment to plan members. Some managed care systems don't offer medical treatment themselves. Rather, they offer different levels of financial coverage based on whether you visit in-network or out-of-network care providers. HMOs, on the other hand, have a system of physicians and hospitals that are involved in a specific coverage structure. If you're part of a Health Maintenance Organization, you are only covered if you go to a physician within the HMO network.
HMO (Health Maintenance Organization) is one of three managed care health insurance systems in the United States. An HMO is designed to offer financial support and medical treatment to plan members. Some managed care systems don't offer medical treatment themselves. Rather, they offer different levels of financial coverage based on whether you visit in-network or out-of-network care providers. HMOs, on the other hand, have a system of physicians and hospitals that are involved in a specific coverage structure. If you're part of a Health Maintenance Organization, you are only covered if you go to a physician within the HMO network.
an HMO contracts with a group of physicians to deliver client services. The sponsor then compensates the medical group on a negotiated per capita rate
An HMO means Health Maintenance Organization. HMO is a form of health insurance that offers a wide range of healthcare services through a network of providers who agree to supply services to its members.