A certified PPO is a plan certified by the Department of Health, owned, operated or administered by an entity that has the capacity to establish a network of service providers that provides or arranges for the coordination and delivery of all required services.
Benefits of a certified PPO model include:
Direction of Care for 30 days from the first visit with a PPO provider
Discounted fee arrangements with PPO participating providers
Mandatory care management including Utilization Review, Return-to-Work, and Telephonic and Field Case Management