PPO stands for Preferred Provider Organization. The Innovations Hospital PPO extends higher levels of benefits when members use a participating hospital. There is no difference in reimbursement for non-hospital providers.
Members are able to seek medical care from any provider.
Members must satisfy a deductible before New West makes payment. When members select a participating hospital provider, they receive a higher level of benefits than they do when a non-participating hospital is selected. Depending on the Innovations plan selected by you and your employer, some services such as physician office visits, accident benefits, and preventive services benefits, mammograms, and well baby care may be available without having to meet your deductible. Check your plan Outline of Coverage to confirm the benefits associated with your plan. Once your deductible is satisfied, you are responsible for the coinsurance amount associated with your plan plus any balance billing from non-participating providers.