ELIZABETH B ROTH M.D.
Accepted Insurance for NPI 1982925327
Urology - Pediatric Urology in Milwaukee, WI

NPI Status: Active since June 21, 2010

Contact Information

9000 W WISCONSIN AVE
PEDIATRIC UROLOGY
MILWAUKEE, WI
ZIP 53226
Phone: (414) 266-3794
Fax: (414) 266-1752

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Accepted Health Plans and Insurance Coverage

This registry outlines the health plan networks and insurance coverage profiles associated with ELIZABETH B ROTH M.D., a practicing urology professional in Milwaukee, WI. Compiled from official data resources, this interface is designed to help you determine if your policy is accepted at this practice location. Currently, the provider is listed across 141 individual coverage options managed by medical networks, including networks like Anthem Blue Cross and Blue Shield, Aspirus Health Plan, and CareSource (Common Ground Healthcare). Please use the filtering dashboard below to search for your specific plan by name, narrow results by a single carrier corporate network, or toggle between plan types (HMO, PPO, EPO) to check your status before coordinating an upcoming clinic visit.

Fitler by Network Type

Anthem Blue Cross and Blue Shield

Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI055000279475WI055001179475WI055001279475WI055001379475WI0550054
Anthem Bronze Pathway/Lean HSA (+ Incentives)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI055000179475WI055000879475WI055000979475WI055001079475WI0550042
Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI055002979475WI055003279475WI055003979475WI055004079475WI0550052
Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560003
Anthem Bronze Preferred/Broad HSA (+ Incentives)
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560002
Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560006
Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI055000679475WI055002079475WI055002179475WI055002279475WI0550046
Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI055003179475WI055003379475WI055003679475WI055003879475WI0550056
Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives)
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560005
Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560008
Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI055000779475WI055002379475WI055002479475WI055002579475WI0550048
Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives)
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560001
Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI055000379475WI055001479475WI055001579475WI055001679475WI0550044
Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI055000579475WI055001779475WI055001879475WI055001979475WI0550050
Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI055003079475WI055003479475WI055003579475WI055003779475WI0550058
Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives)
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560009
Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives)
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560004
Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

79475WI0560007

Aspirus Health Plan

HMO Bronze $0 Medical Deductible
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010016
HMO Bronze 10000
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010009
HMO Bronze 7500
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010011
HMO Catastrophic 10600 with 3 free PCP visits
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010008
HMO Gold 2000
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010015
HMO Gold 2700
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010007
HMO HDHP Silver 5900
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010013
HMO Silver 6000
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010012
HMO Silver 6600
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0010001
POS Bronze 7500
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0020005
POS Bronze 8500
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0020003
POS Silver 6000
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ASPIRUSSIGN Tier

Accepted Plan ID Variations

86584WI0020001

CareSource (Common Ground Healthcare)

CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030003
CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060023
CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay)
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030027
CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060015
CareSource (Common Ground Healthcare) Bronze Standard $7500
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030041
CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060003
CareSource (Common Ground Healthcare) Gold $0 Ded
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030005
CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060025
CareSource (Common Ground Healthcare) Gold $3300
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030017
CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060006
CareSource (Common Ground Healthcare) Gold Standard $2000
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030043
CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060001
CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030023
CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060012
CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030047
CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060011
CareSource (Common Ground Healthcare) Silver Standard $6000
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0030042
CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87416WI0060002

HealthPartners

NE WI Select $3,150 Plus Silver
PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130033
NE WI Select $3,800 HSA Silver
PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130037
NE WI Select $6,000 Standard Silver
PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130034
NE WI Select $6,800 Plus Bronze HSA
PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130035
NE WI Select $7,500 Standard Bronze HSA
PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130036
NE WI Select $8,400 HSA Bronze
PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130038
Oak $1,300 Gold
PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130001
Oak $2,000 Standard Gold
PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NETWORK Tier

Accepted Plan ID Variations

20173WI0130011

Medica

Medica Individual Choice Bronze $0 Copay PCP Visits
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130041
Medica Individual Choice Bronze HSA
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040011
Medica Individual Choice Bronze Share
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040029
Medica Individual Choice Bronze Share
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130029
Medica Individual Choice Expanded Bronze Standard
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040073
Medica Individual Choice Expanded Bronze Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130073
Medica Individual Choice Gold $0 Copay PCP Visits
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040074
Medica Individual Choice Gold $0 Copay PCP Visits
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130045
Medica Individual Choice Gold Share
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040076
Medica Individual Choice Gold Share
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130074
Medica Individual Choice Gold Standard
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040055
Medica Individual Choice Gold Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130055
Medica Individual Choice Silver $0 Copay PCP Visits
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040075
Medica Individual Choice Silver $0 Copay PCP Visits
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130047
Medica Individual Choice Silver Share
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040027
Medica Individual Choice Silver Share
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130076
Medica Individual Choice Silver Standard
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

57845WI0040057
Medica Individual Choice Silver Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73751ND0130057

Sanford Health Plan

Sanford Individual TRUE $1,750
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: SHPTRUE Tier

Accepted Plan ID Variations

31195SD008001889364ND0090018
Sanford Individual TRUE $10,600
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: SHPTRUE Tier

Accepted Plan ID Variations

31195SD008001589364ND0090015
Sanford Individual TRUE $3,500
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: SHPTRUE Tier

Accepted Plan ID Variations

31195SD008000889364ND0090008
Sanford Individual TRUE $4,750
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: SHPTRUE Tier

Accepted Plan ID Variations

31195SD008001689364ND0090016
Sanford Individual TRUE $6,500
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: SHPTRUE Tier

Accepted Plan ID Variations

31195SD008000789364ND0090007
Sanford Individual TRUE $7,200 HSA Qualified
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: SHPTRUE Tier

Accepted Plan ID Variations

31195SD008000989364ND0090009
Sanford Individual TRUE Standardized $2,000
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: SHPTRUE Tier

Accepted Plan ID Variations

31195SD008002889364ND0090028
Sanford Individual TRUE Standardized $6,000
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: SHPTRUE Tier

Accepted Plan ID Variations

31195SD008002789364ND0090027
Sanford Individual TRUE Standardized $7,500
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: SHPTRUE Tier

Accepted Plan ID Variations

31195SD008002689364ND0090026

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0100019
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0110005
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0100022
UHC Bronze Standard (No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0100001
UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0100002
UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0110002
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0100012
UHC Gold Standard (No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0100010
UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0100020
UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0110006
UHC Silver Standard (No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0100005
UHC Silver Value ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0100008
UHC Silver Value+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

80180WI0110004
No coverage plans found coordinating with your query criteria.

Coverage Information & FAQs

This provider accepts health insurance plans managed by the following insurance companies: Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners, Medica, Sanford Health Plan, UnitedHealthcare. You can filter specific policies or search for unique plans using the open dashboard controls located above.
Yes, registry files confirm this provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for covered services. Additionally, the provider is officially enrolled in the PECOS program (Provider Enrollment, Chain, and Ownership System), verifying that they are certified to order, refer, or prescribe services to Medicare beneficiaries.
ELIZABETH B ROTH M.D. is enrolled across the following managed care network types: EPO, HMO, POS, PPO.
  • HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.
  • PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.
  • EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.
  • POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.