An HMO contracts with medical facilities, physicians, employers, and sometimes individual
patients to provide medical care at a fixed cost.
Many HMO's require prior approval for any medical care received. A primary care physician is assigned to each patient and serves as a "gatekeeper," monitoring medical care and giving approval for a specialist referral when needed.
Some HMO's may limit the patient to selected hospitals or medical facilities, therefore, it is necessary to always have prior approval before seeking medical care. It is important to check the individual policy of your HMO prior to receiving any medical care.
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