However, this often comes at the expense of the patients' ability to manage their own health care treatments. Evaluating the network When evaluating a PPO network, first inquire about the company's screening process when signing up physicians. A screening process should ideally include background checks and analysis of any previous malpractice issues. Also ask how many of their network physicians the American Board of Medical Specialties has certified. To be certified, the physician must demonstrate competency in a specialty by passing tests or meeting training requirements.
Some plans sign up doctors simply to boost their numbers.
To get a better sense of the availability of doctors in the network, ask what percentage of their doctors is actually accepting new patients. Also examine how second opinions are handled and how disputes in treatment are settled. PPOs should have a set procedure in place for disagreements to be aired before a grievance board. Examining the policy The ability to opt out of the network often lulls PPO members into a sense of false security. If the network is not up to snuff, people feel they can simply go outside the network for care.