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Why do doctors prefer PPO?

HMO plans might involve more bureaucracy and can limit doctors ability to practice medicine as they see fit due to stricter guidelines on treatment protocols. So just as with patients, providers who prefer a greater degree of flexibility tend to prefer PPO plans.

Does PPO require prior authorization?

Prior authorization is a way for a PPO to make sure its only paying for healthcare services that are really necessary, so the insurers might require you to get pre-authorization before you have expensive tests, procedures, or treatments.

Do I need a referral with Blue Cross PPO?

No referrals are needed; however, you may have to pay for services received and file a claim for reimbursement. Some out of network doctors will file the claims with the insurance companies for you and some will make you pay them in full and file for reimbursement on your own. It all depends on the doctor.

Do I need a referral to see a specialist with Blue Cross Blue Shield Illinois?

You do not need a referral to see a specialist or behavioral health care provider. You also dont need a referral to visit a hospital. You can get care from an in-network or out-of-network provider, but you will likely pay more for non-emergency services if you dont stay in network.

Which type of insurance requires a referral?

Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plans network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.