What is a Participating or PPO Provider?
A Participating or PPO Provider is a doctor, hospital or other health care provider that participates in the Anthem Blue Cross PPO Prudent Buyer - Student Health Network.
The advantage to using a PPO Provider is that these providers have agreed to accept a predetermined fee or Preferred Allowance as payment for their services. Non-PPO providers have not agreed to any prearranged fee schedule, therefore any charges in excess of the insurance payment may be the student's responsibility. Consequently, when insured students use PPO Providers, out-of-pocket expenses will be less because any applicable cost sharing will be based on a Preferred Allowance.
The insured person should be aware that PPO hospitals may be staffed with Non-PPO providers. Receiving services or care from a Non-PPO provider at a PPO hospital does not guarantee that all charges will be paid at the PPO provider level of benefits.
How do I find a PPO Provider?
Click the 'Search for Provider' button to locate a PPO Provider.
Network participation is subject to change, so please verify with the provider that they are participating in the network when making an appointment or at the time of service.
- Gallagher Student Health & Special Risk
500 Victory Road, Quincy, MA 02171
- Customer Service