Bill Payment
Bill Payment

PPO Name

Last update
August 8, 2022

When reducing bill payment below the rates allowed by the California Official Medical Fee Schedule (OMFS), in the Explanation of Review (EOR) claims administrators must specify the entity with which the provider has a written contract establishing the claim’s administrator's right to PPO discounts.

Most EORs label the column showing PPO discounts with some variation of “PPO Reduction” or “PPO Savings.”

Examples of where to find the PPO 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

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