exclusive provider organization

Organization that is part of a Preferred Provider Organization (PPO) in which enrollees select an EPO provider to act as their primary care physician and serve as the gatekeeper. This gatekeeper approves the maximum level of benefits to which the enrollee is entitled. Characteristics of the EPO include emphasis placed on quality of care, utilization of the primary physician, and specified financial structure with the providers on a fee-for-service basis.

A dental benefits plan that provides benefits only if care is rendered by institutional and professional providers with whom the plan contracts (with some exceptions for emergency and out-of-area services).