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IN NETWORK INSURANCE PLANS
Insurance Information
All patients are encouraged to verify their benefits with their plan administrator by referring to their insurance membership card for contact information. Many insurance companies may be included in the listed plans below.

Springfield Clinic accepts plans that may not be listed below.
Springfield Clinic also contracts directly with some employers.
Please check with your employer or insurance carrier if you have questions about coverage.

Provider
Plan Type
Aetna PPO, EPO & POS
Blue Cross/Blue Shield PPO, Blue Choice and Standard Option
CCN PPO
CIGNA PPO and Gated PPO
Consociate Care PPO
First Health/Personal Care Platinum PPO PPO
Great West PPO
Health Alliance HMO, Caterpillar HMO, PPO, POS,
Custom Choice, Medicare HMO,
Medicare PPO and Medicare Supplement
HealthLink PPO
MultiPlan PPO (Primary and Complementary PPO participants)
Private Healthcare Systems (PHCS) PPO
Riverquest (QHCM) PPO
Medication Assistance Program  


Definitions

Health Maintenance Organization (HMO): HMOs offer prepaid, comprehensive health coverage for both hospital and physician services. An HMO contracts with health care providers, e.g., physicians, hospitals, and other health professionals, and members are required to use participating providers for all health services. Members are enrolled for a specified period of time. Model types include staff, group practice, network, and IPA.

Preferred Provider Organization (PPO): Some combination of hospitals and physicians that agrees to render particular services to a group of people, perhaps under contract with a private insurer. The services may be furnished at discounted rates and the insured population may incur out-of-pocket expenses for covered services received outside the PPO if the outside charge exceeds the PPO payment rate.

Point-of-Service (POS): Also known as an open-ended HMO, POS plans encourage, but do not require, members to choose a primary care physician. As in traditional HMOs, the primary care physician acts as a "gatekeeper" when making referrals; plan members may, however, opt to visit non-network providers at their discretion. Subscribers choosing not to use the primary care physician must pay higher deductibles and copays than those using network physicians.

Workers Compensation: A state-mandated program providing insurance coverage for work-related injuries and disabilities.

Indemnity: A plan which reimburses physicians for services performed, or beneficiaries for medical expenses incurred. Such plans are contrasted with group health plans, which provide service benefits through group medical practice.

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