EPO – Exclusive Provider Organization
A product offered by a health insurance company that, like an HMO, controls cost in part by generally restricting access only to healthcare providers who have contracts with the health insurance company (contracted providers are also referred to as in-network providers).
See Section 627.6472, F.S. for definitions of exclusive provider and exclusive provider provision.
FISO – Fiscal Intermediary Services Organization
A company that contracts with an HMO’s in-network providers and that collects payments on behalf of the providers from the HMOs.
HMO – Health Maintenance Organization
An MCO that provides comprehensive health coverage and that controls cost in part by generally restricting access only to healthcare providers who have contracts with the HMO.
Pinner Construction, In Lawsuit Against Arch Insurance Manager, Alleges Manager Committed Fraud After Arch Denied Performance Bond Coverage
Pinner also made allegations of another possible fraud by Arch, claiming that the apparent owner of Pinner s insured subcontractor said Arch told him to lie to Pinner about his status as the indemnitor of an Arch insurance policy
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ANAHEIM, Calif., Dec. 10, 2020 /PRNewswire/ Pinner Construction, a leading public building construction company based in Anaheim, California, has sued an Arch Insurance Company manager for allegedly fraudulent representations concerning Pinner s right to bring in substitute subcontractors to complete the HVAC-plumbing work after the subcontractor on which Arch underwrote a performance bond allegedly walked off the job.