Posts Tagged Medical
If the person reviewing your letter feels you are making a good case for your state agency or a potential lawsuit, the HMO will think twice about continuing to deny the requested medical care. If such letters find their way to lawyers for the HMO, and the lawyers feel that the HMO is threatened by [...]
Your first line of attack for getting specialized or other medical care from someone other than your general physician is your general physician. In functioning as the gatekeeper, your general physician determines whether to refer you for specialized or other medical care.
General or primary care physicians for HMOs are provided with direct and indirect incentives to limit the use of specialists, testing, drugs, and other types of medical care. This has proven to be a controversial and difficult matter.
An essential part of the introductory process is for you to arrange to send all medical records for you (and your family) to your new general physician. Remember that some medical records—such as x-rays, CAT scans, MRIs, sonograms, and some medical reports—are often retained at hospitals or other facilities you may have visited.
When you join an HMO, it is important to begin the relationship in the best possible manner. The quality of services you receive from your HMO will be enhanced if you follow a few simple principles in dealing with it.