Appro-Rx

Description

The use of health care providers who have not contracted with the health plan to provide services. Members enrolled in preferred provider organizations (PPO) and point-of-service (POS) coverages can go out-of-network for covered expenses, but will pay additional costs in the form of deductibles and coinsurance and will be subject to benefit and lifetime maximums. Because reduced fees are not negotiated with out-of-network providers, Paramount will calculate reimbursement based on the usual, customary and reasonable charge, (see definition). Members are responsible for all charges above UCR in addition to any deductible and coinsurance provisions.

Our only revenue source is a fixed fee for managing your costs. You pay only for the services you use. We provide you with the cleanest, clearest contract in the industry—with no "mystery fees" after it’s signed.

Joseph Edward Schmitz is an American lawyer, former Inspector General of the Department of Defense and a former executive with Blackwater Worldwide, a private contractor providing security services to the U.S. State Department and the U.S. military.

Fact sheet

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