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Prospective Payment Systems (PPS)

A Medicare payment plan including pre-determined payment rates based on a patient's diagnosis or level of resource utilization. All Medicare providers are reimbursed under this plan through either a scheduled fee or prospective payment system.

Point-of-service Plan (POS)

Insurance plans that allow enrollees to choose between in-network or out-of-network care providers, though the enrollee will generally pay less for in-network care.