CPB (Certified Professional Biller) Certification Practice Exam

What is the full form of EPO as used in healthcare administration?

1. Electronic Media Claim

2. Exclusive Provider Organization

3. Electronic Health Record

4. Employer Group Health Plan

The correct answer is: Exclusive Provider Organization

The full form of EPO in healthcare administration is Exclusive Provider Organization. This term describes a type of managed care health insurance plan that offers a network of healthcare providers to its members. The key feature of an EPO is that it requires members to use the services of providers that are within this network for coverage, except in an emergency. This structure incentivizes cost control and encourages members to seek care within the network to avoid higher out-of-pocket expenses. In contrast, the other options represent different concepts within healthcare administration. Electronic Media Claim refers to the method of submitting claims electronically rather than on paper. Electronic Health Record pertains to the digital version of a patient’s paper chart, containing their comprehensive health history. An Employer Group Health Plan is a health insurance plan that an employer offers to employees, often encompassing more than just the exclusive provider model. Each of these terms, while relevant in the healthcare context, serves a distinct purpose and accurately reflects its specific role within the industry.