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Home Q & A Board Biology-Related Homework Help Medicine
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Sbermudez Sbermudez
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6 years ago
A patient enrolled in a health maintenance organization (HMO) arrives at an appointment with a specialist.
 
  The nurse explains to the patient that without a(n) ____________________ from their primary care physician (PCP), the insurance company may deny the claim.
  Fill in the blank with correct word.
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#1
6 years ago
ANS:
referral
If the PCP is unable to successfully treat the patient's condition, he or she makes a referral to a specialist. The patient cannot self-refer, and the specialist cannot accept the patient without a referral. In this way, access to more costly care and potentially redundant testing is controlled.
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