EPO - Exclusive Provider Organization

Exclusive provider organization, provides services to the client if needed, it’s basically contract based, a contract between the insurer and the doctor. EPO is also termed as closed plan as the clients have to visits the dentists provided by the insurance company, the clients don’t have any choice in selecting the dentists of there own choice. EPO provides dentists based on contracts, and provide you with the dental care at low costs.

EPO and HMO are some how inter related as in; clients in both the plans are not be able to visit the dentists of there own choice, the costumer have to choose the dentist from the network provided to them by there insurers. In EPO the dentists are not paid until they provide services to the patients, whereas in HMO plan the dentists are paid on monthly bases for the providing services to the clients in plan.

EPO plans bears all the costs spend for dental care of the client, clients can visit the dentists available in the network, as the doctors here are contract based. Emergency services can be provided to the clients as an exception, and if a client wants to visit dentists out of the network then the cost bearer will be the patient.

High profile dentists avoid joining EPO plan, as they require slashing down their fees, in EPO network, some times a dental care professional have a large number of patients and they don’t want to reduce their dental care cost, i.e. why it is difficult to find high profile dentist in EPO plan

The process for submitting their claims is different, dentists or the patients have to submit their claims on time, and insurer must assure the dentist, that the salary will be provided in time.

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