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Commerical Insurance

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Commercial Insurance – United Healthcare PPO
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BUA 211 – Spring 2013
Denise Wehr
Commercial Insurance – United Healthcare PPO
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BUA 211 – Spring 2013
Denise Wehr

The topic I chose to research was commercial insurance, more specifically United HealthCare, which is associated with a preferred provider organization (PPO). A PPO is a health care organization of providers, hospitals, and diagnostic and lab facilities that are contracted together and provide health care services at a reduced cost. PPOs provide significant benefits to the providers who join them. PPOs provide more freedom for the insured to see whom they want to see and not be tied down to a specific group. In most instances, the insured has to pick from the providers that are in that PPO organization. But, there are times there is an out-of-network benefit that allows the insured to see a particular provider who is not within that PPO. The insured does need to select a primary care provider (PCP), so as a result the PCPs are not needed as gatekeepers for patients to see specific specialty providers. No referrals are needed. However, some specialists only will see patients who are referred to them by the PCP. One such PPO plan is United Healthcare. This insurance is a segment of bigger group named UnitedHealth Group (UHG). Richard T Burke created the UnitedHealth Group in 1974 and headquartered in Minnetonka, Minnesota. It is currently on the list of Fortune magazine’s top 500 companies in the US. UnitedHealth Group serves approximately 70 million individuals with a variety of products and services in the healthcare continuum. Its largest single health carrier is United Healthcare, which was created in 1977 as the first network-based health plan for seniors. In the years since, United

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