HMO

Q: HMO

Health Maintenance Organization: An organization that provides a wide range of comprehensive health care services through a designated group or network of doctors, hospitals, labs and other providers. To receive benefits, you must see the doctor you select as your primary care physician first, for care or a referral, except in the case of an emergency. Your choice of doctors is restricted to those in the network. The Primary Care Physician is paid a certain “fixed” fee for each member each month after enrollment. This fee is called a “capitation fee.” In California, women have the option of self-referral to their OB-GYN. Typically the OB-GYN needs to be within the network of physicians that her primary is in (i.e. Sharp Rees-Stealy).

Question

HMO

RNorton22 · Accepted Answer

Health Maintenance Organization: An organization that provides a wide range of comprehensive health care services through a designated group or network of doctors, hospitals, labs and other providers. To receive benefits, you must see the doctor you select as your primary care physician first, for care or a referral, except in the case of an emergency. Your choice of doctors is restricted to those in the network. The Primary Care Physician is paid a certain “fixed” fee for each member each month after enrollment. This fee is called a “capitation fee.” In California, women have the option of self-referral to their OB-GYN. Typically the OB-GYN needs to be within the network of physicians that her primary is in (i.e. Sharp Rees-Stealy).