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> you don't need preauthorizations To be clear, in an HMO you don't need preauthorizations from your insurance but you still need your (not necessarily self-se
by zamfi 3y ago
> you don't need preauthorizations
To be clear, in an HMO you don't need preauthorizations from your insurance but you still need your (not necessarily self-selected) PCP to order care or refer you to a specialist.
- haldujai 3y agoNeeding a referral (an assessment by a physician that something is medically appropriate) is not the same as needing preauthorization (insurance company agreeing to pay) but in any case hence the following "you have to go through your designated primary care provider". Many PPOs and public systems work in the same way, that's more about judicious and appropriate use of resources than payment authorization.
- zamfi 3y agoYes, I was just clarifying because PPOs often do allow you to seek out a specialist without a referral, and without requiring preauthorization.