In which type of health plan is it common for the services to be coordinated through a primary care physician?

Prepare for the Current Procedural Terminology (CPT) Exam. Study with flashcards and multiple choice questions, each question has hints and explanations. Get ready for your exam today!

In a Health Maintenance Organization (HMO), services are typically coordinated through a primary care physician (PCP). This means that when a patient needs medical care, they first consult their PCP, who acts as a gatekeeper to the healthcare system. The PCP provides referrals to specialists and other healthcare services, ensuring that the patient's care is managed, and that it aligns with the HMO's network of providers.

This model promotes a more integrated approach to healthcare, as the primary care physician is responsible for overseeing the patient's overall health and continuity of care. HMOs often encourage preventive care and wellness initiatives, which further solidifies the role of the PCP in coordinating patient services.

Other health plans, such as indemnity insurance, PPOs, and POS plans, offer more flexibility in choosing healthcare providers and do not typically require coordination through a primary care physician. In these plans, patients may seek care from specialists without needing a referral, which contrasts with the structured approach that characterizes HMOs.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy