Q. What is a PPO Network?
A. A PPO (Preferred Provider Organization) Network contracts with hospitals, physicians, and other healthcare providers to participate in a network offering quality health care at competitive rates. These providers have agreed to offer their services at reduced rates. PPOs offer their services to health insurance companies, third party administrators (TPAs), and self-insured employers.

Q. What benefits do members get if they use Signature's providers?
A. The plan design (benefits and coverage) is determined by the member's insurer. Some benefit plans pay a larger portion of the claim if they use a PPO provider, which reduces the member's out-of-pocket expenses. As an example, if a member chooses a Signature Health Alliance PPO provider, their benefits may cover 90% of the claim, but if they use an out-of-network provider, only 70% of the claim may be covered. Some plans have a flat fee (co-pay), which is paid at the time of service. In this case, if a member uses a non-PPO provider, they may be responsible for a percentage of the total billed amount, as well as having a deductible to meet.

Q. What does Repricing mean?
A. Repricing is applying the discount for using an "In-Network Provider" to charges submitted by a doctor's office. The discount and net charges, along with the original claim, are forwarded to the insurance company for payment.

Q. What is Signature Health Alliance's coverage area?
A. Signature Health Alliance's PPO Network covers the entire state of Tennessee

Q. What is the difference between a Provider, a Client, and a Member?
A. A Client is a company or employer group that contracts with Signature Health Alliance to access our providers. A Provider is a physician, other healthcare professionals or a facility that have a contract with Signature and provide health care to members. Members are the individuals that are employed by the company or employer groups.