Exclusive Provider Organization

(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.

Source: NUCC Health Care Provider Taxonomy, version 25.1 · Classification: Exclusive Provider Organization · Specialization: none · Section: Non-Individual

Providers
123
States
9
Cities
58

Exclusive Provider Organizations · showing 61–80 of 123

Exclusive Provider Organizations by state

Top cities

San Juan, PRBayamon, PRGuayama, PRCarolina, PRPonce, PRGuaynabo, PRMayaguez, PRArecibo, PRSan German, PRAguadilla, PRDorado, PRYauco, PRHumacao, PRAndover, MASanta Isabel, PRCaguas, PR
Health Maintenance Organization302R00000XPoint of Service305S00000XPreferred Provider Organization305R00000X

About taxonomy 302F00000X

What does taxonomy code 302F00000X mean?

302F00000X is the NUCC taxonomy code for Exclusive Provider Organization. The prefix 30 denotes the Managed Care Organizations grouping, 2F the Exclusive Provider Organization classification, and 00000 indicates no further specialization.

How many Exclusive Provider Organization providers have an NPI?

NPIFinder currently indexes 123 providers who list 302F00000X on their NPI record, 108 of them as their primary taxonomy. Puerto Rico, Massachusetts, Texas have the most.

Is a taxonomy code the same as board certification?

No. Taxonomy codes are self-reported when a provider applies for an NPI and are not verified by a licensing or certifying board. Check the state license number on the provider profile for licensing status.

How do I find a Exclusive Provider Organization near me?

Use the state filter on this page, pick one of the top cities, or search the registry with your city or ZIP code in the location box above.