Managed Care Organizations Healthcare Taxonomy Code 302F00000X
HealthProviders DB is a comprehensive database of healthcare providers, including a complete directory of all Exclusive Provider Organizations.
As of today, the following are the total number of Exclusive Provider Organizations nationally, in your state, and near your location.
Medicare
The following are the total number of Exclusive Provider Organizations that accept Medicare in your state, the number that have opted out of Medicare, and the total number excluded from participation in Medicare nationwide.
Alaska – Alabama – Armed Forces Pacific – Arkansas – American Samoa – Arizona – California – Colorado – Connecticut – District of Columbia – Delaware – Florida – Federated States of Micronesia – Georgia – Guam – Hawaii – Iowa – Idaho – Illinois – Indiana – Kansas – Kentucky – Louisiana – Massachusetts – Maryland – Maine – Marshall Islands – Michigan – Minnesota – Missouri – Northern Mariana Islands – Mississippi – Montana – North Carolina – North Dakota – Nebraska – New Hampshire – New Jersey – New Mexico – Nevada – New York – Ohio – Oklahoma – Oregon – Pennsylvania – Puerto Rico – Palau – Rhode Island – South Carolina – South Dakota – Tennessee – Texas – Utah – Virginia – Virgin Islands – Vermont – Washington – Wisconsin – West Virginia – Wyoming
Select the State name above or from the HealthProviders DB App filter panel to show the list of Exclusive Provider Organizations by State. In addition, you can also narrow the list by City and more from the filter panel.
You can download the Exclusive Provider Organizations dataset using HealthProviders DB Export.
What do Exclusive Provider Organizations do?
An EPO is a form of PPO, in which patients must visit a caregiver who is specified on its panel of providers (who is a participating provider).
If a visit to an outside (non-participating) provider is made, the EPO offers very limited or no coverage for the medical service.
While similar to a PPO in that an EPO allows patients to seek care outside the network, if they do so, they are required to pay the entire cost of the care themselves.
An EPO differs from an HMO in that EPO physicians do not receive capitation; instead, they are reimbursed only for the services they actually provide.
An organization identical to a preferred provider organization, except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers.
No benefits are available when non-contracting providers are used, except in specific emergencies.
Managed Care Organizations
Health Maintenance Organizations
Healthcare Taxonomy Code 302R00000X
A form of health insurance in which its members prepay a premium for the HMO’s health services, which generally include inpatient and ambulatory care.
Point of Services
Healthcare Taxonomy Code 305S00000X
This product may also be referred to as an open-ended HMO and offers a transition product that incorporates features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the network for an additional cost.
Preferred Provider Organizations
Healthcare Taxonomy Code 305R00000X
A group of physicians and/or hospitals that contract with an employer to provide services to their employees.