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exclusive provider organization

EPO's are similar to PPO's in their organization and purpose. Unlike PPO's, however, EPO's limit their beneficiaries to participating providers for their health care services. In other words, beneficiaries covered by an EPO are required to receive all of their covered services from providers that participate in the EPO, similar to an HMO. The EPO does not cover services received from other providers. Some EPO's parallel HMO's in that they not only require exclusive use of the EPO provider network, but also use a "gatekeeper" approach to authorize non-primary care services.

Definition extracted with permission from American Academy of Family Physicians: Family Physicians and Managed Care

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