Bill Payment
Bill Payment

Identifying PPO and Discount Contracts on EORs

Last update
February 6, 2023

When reducing bill payments based on a PPO or Discount Contract the Explanation of Review (EOR) issued by claims administrator should display the name of the entity authorized to take the discount.

The entity listed on the EOR may be the same entity with whom the provider has a PPO or Discount Contract agreement.  The entity listed on the EOR may also be different entity, not recognized by the provider, that is paying to utilize the PPO or Discount Contract agreement the provider signed.

When a PPO or Discount Contract reduction is taken, most EORs display a column showing the discount with some variation of “PPO Reduction”, “PPO Savings”, or “Network Reduction”.

Examples of where to find the PPO or Discount Contract Name

Sedgwick Claims Management Services

Gallagher Bassett

State Compensation Insurance Fund (CA)

Liberty Mutual Insurance

Zurich Insurance North America

Travelers

Berkshire Hathaway Homestate Companies

ESIS, Inc.

CorVel

Broadspire

Tristar Risk Management

Intercare Holdings Insurance, Inc.

AmTrust North America

Athens Administrators

Cannon Cochran Management Services Inc.

The Hartford

Insurance Company of the West

Keenan & Associates

Employers Compensation Insurance Company

The Zenith

Sedgwick Claims Management Services

Gallagher Bassett

 

State Compensation Insurance Fund (CA)

Liberty Mutual Insurance

Zurich Insurance North America

Travelers

Berkshire Hathaway Homestate Companies

ESIS, Inc.

CorVel

Broadspire

Tristar Risk Management

Intercare Holdings Insurance, Inc.

AmTrust North America

Athens Administrators

Cannon Cochran Management Services Inc.

The Hartford

Insurance Company of the West

Keenan & Associates

Employers Compensation Insurance Company

The Zenith

How did you like the article ?