Participating Providers agree to accept the scheduled payment or their usual and customary fee -- whichever is less -- as payment in full on all eligible services. Copayments and services rendered that are ineligible for benefit reimbursement may be billed to the enrollee. All payments for eligible services are made directly to the Participating Provider.

POMCO utilizes the most recent American Medical Association Physicians' Current Procedural Terminology (AMA CPT) Manual for reviewing services billed. Reimbursement levels are based on proper representation of services rendered and benefits allowed for in the underlying client plan.