Usually your first contact for health care under a health maintenance organization (HMO) or point-of-service (POS) plan. This is often a family physician, internist, or pediatrician. A primary care physician monitors your health, treats most health problems, and authorizes referrals to specialists, if necessary.----------[ Back
A doctor; such as a family practitioner, internist or pediatrician, who coordinates the overall care of patients who belong to an HMO or other managed care plan.
a physician who practices any of the generalist specialties of family practice, pediatrics and general internal medicine
Your regular doctor. This term is also used by insurance companies. Often, you must choose a Primary Care Physician (a family practice physician, for example) from a list of doctors who are under contract with an insurance company. Referrals to other doctors (specialists, etc.) will come from that particular physician.
a participation provider selected by an HMO member who is responsible for providing all primary care covered services and for authorizing and coordinating all covered medical care, including referrals for specialists services.
The physician who provides your routine health care services, and is your first point of contact when you become sick. This physician can easily refer you to a specialist (such as a surgeon) should you require care outside the scope of his or her expertise.
Physician who provides or authorizes all care for that particular member, any referrals to specialists must be authorized.
A doctor whose practice is devoted to internal medicine, family/general practice, or pediatrics. Some insurance companies consider Obstetrician/gynecologists primary care physicians.
A personal physician selected by you to supervise and manage all of your health care services, referred to as a PCP and used by HMO plans and some PPO plans. Referral to specialists is usually required by HMO plans while not a requirement of PPO plans using a PCP to receive the best benefits for certain services.
As currently used in SCHS publications, the term refers to a federal or non-federal practitioner who: Is licensed or registered with the Board of Medical Examiners Holds the Doctor of Medicine or Doctor of Osteopathy degree and Practices in one of the following categories: Pediatrics Family Practice General Practice Internal Medicine Obstetrics/Gynecology Physicians who are not primary care physicians would include surgeons and emergency room practitioners. Physician assistants and nurse practitioners may each be counted as .66 of a physician and added to primary care physicians as referred to in the SCHS publication N.C. Pocket Guide.
The doctor who coordinates all the health care and medical needs of an insured, including basic care, preventive services, referrals to specialists and hospitalization arrangements. A Primary Care Physician can be a General Practitioner, Internist, Pediatrician or an Obstetrician/Gynecologist if he/she is contracted to serve as a PCP by the insurer. Typically required in an HMO (Health Maintenance Organization).
A physician trained in one or more of the following areas: family medicine, general practice, general internal medicine, and pediatric medicine. Some health plans include obstetrics-gynecology as one of the types of primary care physicians.
a physician whose practice is devoted to general internal medicine, family/general practice, and pediatrics. Some plans may consider an obstetrician/gynecologist as a primary care physician.
a physician, usually a pediatrician, family practitioner or internist who oversees the total care of patients, referring the patient to other professionals as appropriate.
a physician who serves as a group member's primary contact within the health plan. In a managed care plan, the Primary Care Physician provides basic medical services, coordinates, and, if required by the plan, authorizes referrals to specialists and hospitals.
A physician chosen to be an individuals primary practitioner. Most often primary care physicians practice general medicine, internal medicine or family medicine.
A doctor who practices in the field of general medicine, family practice, or internal medicine. A PCP coordinates all aspects of a person’s health care and makes referrals to specialists and hospitals as needed.
Your PCP is your partner in managing and coordinating your health care services. If you are a member of an HMO plan, your PCP is responsible for coordinating all of your medical care, including diagnosis, treatment, referrals to specialists, hospitalization, and follow-up care. He or she works with a team of health care professionals, which may include physician assistants and nurse practitioners, to provide your treatment. Your PCP may be certified in internal medicine, family practice, general practice, or pediatrics. Women may also choose a gynecologist/obstetrician as their secondary PCP.
A physician who devotes the majority of his/her practice to family or general medicine.
The physician in a managed care plan responsible for coordinating all of the care, including hospital and specialist services, received by a covered participant.
Provides continuity and integration of healthcare, both preventive and curative over a period of time and coordinates the care the patient receives. Includes those physicians practicing in the specialties of family practice, internal medicine, obstetrics and gynecology (OB/Gyn), and pediatrics.
A doctor who treats common illnesses and injuries. This doctor will coordinate all your medical care. You can choose a family practitioner, an internist or a pediatrician. Your doctor, your HMO and you form a team. You'll work together to find the right care to help you get healthy and stay well.
A doctor trained to give basic health care. A PCP is the first doctor seen for a specific health problem. The PCP then coordinates with other health-care professionals for future care and/or preventative health care. Oftentimes, Medicare managed care plans require a participant to see their PCP before seeing any other health-care provider.
A physician -- general practitioner, family physician, pediatrician, some internists and OB/GYNs -- who serves as the patient's first point of contact with the health care system and coordinates the patient's medical care.
Your primary care physician (PCP) is a health care professional that you choose to coordinate all of your health services, visits, etc. Each plan has a network of physicians that you can select by looking on the web page of the plan that you choose, or in hard copy directories available in the Human Resources Department. Your PCP is considered your primary doctor and, as such, will be the first point of contact in understanding your health care needs and history. Your PCP will make arrangements for you to see specialists outside of his/her specialty if necessary. Typically, your PCP will refer you to a provider within the same hospital group in which they are affiliated. Note that you must choose a PCP if you are a member of either the POS or HMO plan.
refers to the physician or physician assistant who has been selected to coordinate most of your health care needs. A listing of PCPs from which you can choose is provided by your Managed Care Plan.
The doctor who is consulted first when a health problem occurs and on whom the patient relies for advice, referrals, and ongoing care.
A health care professional who is trained to give you basic care. Your PCP is responsible for providing or authorizing covered services while you are a plan member.
Once called a general practitioner, this is the physician who is the first to care for a patient's medical needs and who knows the patient on an ongoing basis. In an HMO, the primary care physician is the gatekeeper, controlling access to other physicians and to hospitals.
A physician, usually an internist, pediatrician or family physician, devoted to general medical care of patients. Most HMOs require members to choose a primary care physician, who is then expected to provide or obtain authorization for all care for that patient.
Under a health maintenance organization (HMO) or point-of-service (POS) plan, usually your first contact for health care. This is often a family physician, internist, or pediatrician. A primary care physician monitors your health, treats most health problems, and refers you to specialists if necessary.
the physician who provides primary care; "the primary care physician acts as a gatekeeper to the medical system"
a contracted physician (general or family practitioner, internist, pediatrician and sometimes obstetrician/gynecologist)
a member physician who is responsible for coordinating the delivery of covered services and benefits to the member
a physician, usually specializing in internal medicine, family/general practice or pediatrics, and is responsible for overseeing the consumer's medical needs in a managed care system
Some plans require a primary care physician to coordinate a memberâ€(tm)s healthcare. These participating providers are family practice, internal medicine and pediatric physicians. Registered Optima Health plan members who are required to choose a PCP may do so online at My Optima.
A physician in general practice or who specializes in pediatrics, family practice or internal medicine that has been selected by the covered individual from the list of primary care physician's in the Plan directory. CIGNA’s HMO plan requires a member to choose a PCP and to always see the PCP for a referral to a specialist.
The physician you are required to designate if you are in an HMO (and have the option of designating if you are in the Choice POS II Program). A PCP coordinates care, including referrals to specialists and other providers. Each covered family member can designate a different PCP.
A physician who is trained to give you basic care. Your primary care doctor is the doctor you see first for most health problems and may talk with other doctors and health care providers about your care and refer you to them. In many Medicare managed care plans, you must see your primary care doctor before you see any other health care provider.
PCPs generally include internists, family practitioners, general medicine practitioners and pediatricians. In addition to providing care, PCPs may arrange, authorize, coordinate and monitor the care of HMO patients. HMO participants may choose a PCP from among the many PCPs in the HMO network.
You select a doctor to manage and coordinate virtually all of the health care services you receive. Your Primary Care Physician provides you with routine medical care and represents your case to the insurer to get authorization for treatments that require pre-certification. See also Gatekeeper. Please Note: In HMOs, you must get a referral from your PCP to see a network specialist. A main difference between an HMO and a PPO is that in a PPO you do not need to name a PCP, and you can self-refer to any specialist in the network.
Some health insurance plans require members to select and seek treatment from a primary physician who either provides treatment or refers the member to an appropriate specialist within the approved health care network.
A physician chosen by the insured to be responsible for providing, prescribing, authorizing and coordinating all medical care and treatment. This includes referrals to specialists. PCPs include physicians practicing family medicine, internal medicine, pediatrics and often, OBGYNs.
A generalist physician, such as a family practitioner, pediatrician, or general internist, who may act as a "gatekeeper" in a managed care organization.
Primary Care Physician (PCP): A physician who is trained to provide basic patient care. A PCP is the doctor seen first for most health problems. He or she makes sure that patients receive the necessary care to maintain their health. He or she may also consult with other doctors and health care providers regarding a particular patient's care and refer that patient to them. In many managed care plans, enrollees must see their primary care physician before seeing any other health care provider. (See also: Gatekeeper)
refers to your main healthcare provider or refernece in an HMO setting to the provider that must refer you for specialist care in order to recieve benefits.
See Personal Care Physician.
The doctor you choose as your main health care provider. Under most HMOs, your PCP must give you permission to see a specialist.
An internist, pediatrician, family physician, general practitioner, or in some instances an obstetrician/gynecologist. If you are enrolled in an HMO, you usually must choose a PCP from a list of participating providers. The PCP coordinates your care and makes referrals to specialists as needed.
The doctor you choose to give you most of your health care.
the physician one visits for physical exams and minor illnesses
A PCP is a family physician – family practitioner, general practitioner, internist or pediatrician - who is responsible for delivering or coordinating care.
A medical professional (as a general practitioner or a pediatrician) with whom a patient has initial contact and by whom the patient may be referred to a specialist for further treatment.
An HMO doctor chosen by you (and each family member) to coordinate your health care. If you participate in an HMO, you must always see your PCP first. Your PCP will provide treatment or refer you to an HMO specialist.
A physician that the employee selects from a listing of in-network providers. This person coordinates medical care for the individual and when appropriate makes referrals to specialists. Different primary care physicians may be selected by each member of the family.
A family practice physician, a pediatrician or a general internal medicine physician. The primary care physician provides, coordinates and/or is actually aware of all aspects of the member's health care and history.
A physician who has direct contact with a patient without referral from another physician and who is responsible for providing and coordinating all the patient’s health care needs. Also referred to as a PCP.
Healthcare provided by general practitioners, family practice, internal medicine, obstetricians and pediatricians usually in a clinic setting.
A primary care physician is one who practices in basic or general healthcare (ie. Family practice, pediatrician, internal medicine)
The physician responsible for coordinating and managing the health care needs of a patient in the managed care environment. Most frequently, physicians who are certified in the specialties of Internal Medicine, Family or General Practice, or Pediatrics are eligible to be primary care physicians.
Your primary care physician, or “PCP,†is the doctor you see first for most health problems. He or she makes sure that you get the care that you need to keep you healthy. He or she also may talk with other doctors and health care providers about your care and refer you to them. In many Medicare managed care plans, you must see your primary care doctor before you see any other health care provider.
Your personal physician. The doctor you see for regular check-ups and most medical care.
( Related information) Physicians with the following specialties: group practice, family practice, internal medicine, obstetrics/gynecology, and pediatrics. The PCP is usually responsible for monitoring an individual's overall medical care and referring the individual to more specialized physicians for additional care.
means a duly licensed Doctor of Medicine or Osteopathy, formally selected by the Member to assume primary responsibility for his/her care.
A health care licensed physician who is trained to provide you care. Your PCP is responsible for coordinating your care while a member of AdvantageCare.
Primary care physicians generally include physicians with the following specialties: general medicine, family practice, internal medicine, obstetrics/gynecology, and pediatrics.
Primary deliverers and managers of health care, central to controlling costs and utilization. The PCP provides basic care to the enrollee, initiates referrals to specialists, and provides follow-up care. Refers exclusively to other contracted providers and admits patients only to contracted hospitals. Usually defined as a physician practicing in such areas as internal medicine, family practice, and pediatrics.
A doctor selected by the enrollee to be the first physician contacted for any medical problem. The doctor acts as the patient's regular physician and coordinates any other care the patient needs, such as a visit to a specialist or hospitalization.
Your first contact for health care; often a family physician, general practitioner or internist, but many women use their gynecologist. A primary care physician monitors your health, diagnoses and treats minor health problems, and refers you to specialists if further care is needed.
The physician selected by HMO members to serve as their personal doctor and provide all basic medical treatments and any referrals to medical specialists. Primary care physicians are prohibited in PPOs and other indemnity health plans. (Also known as a gatekeeper.)
A healthcare professional who is trained to give you basic care. Your PCP is responsible for providing or authorizing covered services while you are a member. You may utilize the Choice 1 option under Secure Health to see your PCP for referral to a specialist within your IPA. Each Secure Health PCP is associated with an IPA.
A PCP is a physician who is designated as responsible for providing specific primary care services. This includes evaluation and treatment of a patient, including decisions regarding referral for specialty care.
A participating provider who is a practitioner specializing in family practice, general practice, internal medicine, OB/GYN services, or pediatrics who supervises, coordinates and provides initial care and basic medical services to an insured.
A Participating Physician who is selected by the Member to be responsible for providing or authorizing the healthcare services covered under this Plan. The PCP may be a Family Practitioner, General Practitioner, Internist or Pediatrician who meets the Plan's criteria for primary care practitioners.
A physician responsible for supervising, coordinating, and providing initial and primary care to patients; for initiating referrals for specialist care; and for maintaining the continuity of patient care
A physician that is employed by or contracts with a managed health care system like an HMO that coordinates all of the member's medical care. A PCP is usually afamily practitioner . PCP's are also known as "gatekeepers" because they control a member's access to medical care within a health plan.
A physician who practices internal or family medicine, pediatrics or general practice and acts as a gatekeeper to decide when patients need to be seen by a specialist. They often stress preventive care and wellness.
some plans require a participant to name a primary care physician—usually a family doctor, internist or pediatrician—to coordinate all medical care. The PCP manages the participant's health care by serving as a main caregiver, and when necessary by referring the participant to another network provider for care. Some plans allow women to name one primary care physician for most care as well as an Ob/Gyn.
A primary care physician (or family doctor) is the first person most people see if they are not feeling well, or are having unusual health symptoms. Primary care physicians will provide a check-up, run general medical tests, and suggest the next course of action.
The physician who is responsible for coordinating all care for an individual patient, from providing direct health care services to referring the patient to specialists and hospital care. Managed care plans such as HMOs rely on PCPs to coordinate subscribers' care.
A physician a member chooses to provide and coordinate all of their medical health care, including specialty and hospital care, for the Blues’ HMO or Point-of-Service (POS) plans. The primary care physician is licensed in the state of Michigan in one of the following medical fields: internal medicine, family practice, general practice, pediatrics, and internal medicine/pediatrics.
a physician that is responsible for providing, prescribing, authorizing and coordinating all medical care and treatment. Note: PPOs typically allow you to go to any doctor in the network, and do not require that you consult with a PCP.
An internist, family practitioner, general practitioner or pediatrician.
A general or family practitioner who serves as the insured's personal physician and first contact with a managed care system. The PCP will usually direct the course of your treatment and/or refer you to other doctors and/or specialists in the network.
A primary care provider such as a family practitioner, general internist, pediatrician and sometimes an ob/gyn. Generally, a PCP supervises, coordinates and provides medical care to members of a plan. The PCP may initiate all referrals for specialty care.
a family practitioner, general practitioner, internist or pediatrician who provides care and coordinates your medical treatment in the Point-of-Service plan. All network PCPs meet qualification standards and are subject to periodic review.
A physician or other medical professional who serves as a group member's first contact with a plan's healthcare system. Also known as a primary care provider, personal care physician or personal care provider.
A doctor specializing in internal medicine (internist), family practice or pediatrics who coordinates all health services of a managed care patient and refers that patient for specialty care. Some plans include obstetricians/gynecologists as primary care physicians.
A physician, who usually specializes in family practice, general practice, internal medicine or pediatrics, who provides or coordinates an HMO member's non-emergency services covered under the member's contract. Each covered family member chooses his or her own PCP from the HMO's network of participating physicians and health care practitioners. Services rendered by a PCP may include: writing referrals for specialists, arranging for planned hospitalizations, arranging for outpatient services and surgery, arranging for approvals required from the HMO for certain covered health care services and coordinating urgent and emergency care when appropriate.
provides first-contact assessment of a patient and continuing care for a wide range of health concerns. Primary medical care includes the diagnosis, treatment and management of health concerns; prevention and health promotion; and ongoing support with family and community intervention where needed.
A doctor of medicine (M.D.) or osteopathy (D.O.) specializing in Family Practice, General Practice, Internal Medicine, or Pediatrics. This doctor contracts with us to provide health services and to coordinate overall health care for Horizon HMO members who have selected them.
Usually your first contact for health care. In most cases, this is a family physician (or some women choose their gynecologist), who monitors your health, diagnoses and treats minor health problems, and refers you to specialists if needed.
Primary care physicians are trained to give basic care. In an HMO, they often coordinate and give you most of your care. In order to see a specialist, you will have to see your primary care physician to get a referral, unless you are in a Point of Service plan (POS). When you join an HMO, you select your primary care physician from a list of doctors who are participating in the Plan. If you already have a doctor you want to continue to see, make sure that s/he is in the plan and is accepting new patients under that plan.
Usually your first contact for health care. This is often a family physician or internist, but some women use their gynecologist. A primary care doctor monitors your health and diagnoses and treats minor health problems, and refers you to specialists if another level of care is needed.
a doctor who provides, arranges, authorizes, coordinates, and monitors the care of HMO members. Primary care physicians are usually internists, family practitioners, or pediatricians. Upon joining an HMO, a member chooses such a doctor from an extensive list of network physicians. Member may select a different primary care physician at any time.
In a managed health care plan, a physician, usually a general or family practitioner, who serves as the insured's personal physician and contact with the managed care plan.
A primary care physician specializes in overall "family" healthcare. PCPs are typically family practitioners, general internists, pediatricians, and sometimes ob/gyns. Generally, a PCP supervises, coordinates, and provides medical care to members of a health plan. The PCP may also initiate all referrals for specialty care.
A health care professional, usually an internist, pediatrician or family physician, devoted to general medical care of patients. Most managed-care plans require members to choose a primary care physician or other primary care provider (such as a nurse practitioner) who then provides or coordinates all care for that patient.
a Participating Physician designated by HPS to provide general care to Members. This physician is responsible for providing or arranging for a Member's Healthcare Services and for maintaining his or her medical records. Primary Care Physicians generally practice in the areas of Family Medicine, Internal Medicine or Pediatrics.
A health care practitioner selected from a list of network physicians who is responsible for coordinating and referring every aspect of the medical care received under certain types of health plans.
a pediatrician, family or general practice physician or internist who oversees ALL your health care, from routine physical examinations to specialist and urgent/ emergent care. This allows your PCP to develop an understanding about you that is difficult for intermittent physicians to match. The close relationship you establish with him/her will enhance accurate diagnoses, preventive medicine and education. If you belong to an HMO, you must choose a primary care physician.
A doctor or other health care professional who provides regular basic care to the enrollee of a managed care plan. The primary care physician is usually a family or general practitioner, pediatrician, internist, or obstetrician/gynecologist. The primary care physician is also responsible for making referrals to specialists, ordering tests, or seeking authorization for hospitalization or surgery.
Your personal doctor who will manage all your health care needs
A doctor or group of doctors responsible for providing primary care services and coordinating all aspects of health for plan members. This may include referring the member to specialists, and making sure the member receives proper rehabilitative services when needed. HMOs use the primary care physician mechanism.
The physician responsible for coordinating the HMO plan member's health care. PCPs are typically Family/General Practitioners, Internists, Pediatricians or OB/GYNs. Your PCP will provide your care or refer you to other specialists when appropriate.
A physician selected by the member, who is part of the plan network, who provides routine care and coordinates other specialized care. The PCP should be selected from the network that corresponds to the plan in which you are a member. The physician you choose as your PCP may be a family or general practitioner, internist or pediatrician.
The doctor a patient sees first for medical care, usually a physician who is in some sense a generalist such as a family or general practitioner, general internist, pediatrician or obstetrician/gynecologist. While these physicians deal with the entire person, sub-specialist physicians deal with a single body system.
A physician, usually a general, family practitioner or internist, who delivers general health care, and is most often the first doctor a patient sees. This physician treats the patient directly, refers them to a specialist (or secondary care physician) or admits them to the hospital.
A doctor trained to give you basic care. Your primary care doctor is the one you see first for most health problems. He or she makes sure you get the care you need to stay healthy. He or she also may talk with other more specialized doctors and healthcare providers and refer you to them. In many Medicare managed care plans, you must see your primary care doctor before you see other healthcare providers.
Under a health maintenance organization (HMO) or point-of-service (POS) plan, a primary care physician is often the first contact for health care. It is usually a family physician, internist, or pediatrician. A primary care physician makes referrals to specialists if necessary.
A "generalist" such as a family practitioner, pediatrician, internist, or obstetrician. In a managed care organization, a primary care physician is accountable for the total health services of enrollees including referrals, procedures and hospitalization.
A physician who serves as a group member's first contact with a plan's health care system.
The physician responsible in an HMO for directing all patient care including referrals to specialists and obtaining necessary pre-certifications. This physician is usually a General Practice, Family Practice, Pediatric or Internal Medicine specialist. In some plays, women may choose an OB/GYN as their primary care physician.
The network physician designated by an employee (and each of his or her dependents) to serve as that employee's entry into the health care system. The PCP often is reimbursed through a different mechanism than are other network providers. This physician sometimes is referred to as the "gatekeeper."
The physician you select to be your first point of contact with the health care system. Usually this is your family doctor or pediatrician. Most managed care plans require you to select a primary care physician, who will serve as your "gatekeeper" to specialty or hospital care.
Doctors who provide general health care services and treatment. PCPs usually include family practitioners, general practitioners, pediatricians and internists.
A primary care physician monitors your health, diagnoses and treats minor health problems, and refers you to specialists if another level of care is needed. This is often a family physician or internist, but some women prefer to use their gynecologist. Provider: Any person (doctor, nurse, dentist) or institution (hospital or clinic) that provides medical care.
Your assigned physician. This physician will manage your care and assign you to a specialist if necessary.
(PCP) Under many plans, you'll be asked to name a family practice doctor, pediatrician or an internal medicine physician as your primary care physician. A PCP is responsible for coordinating all of your care. Any specialist referrals you'll need must first be approved by your PCP in order to be considered a covered expense.
Under many plans, you'll be asked to designate a family practice doctor, pediatrician or an internal medicine physician as your primary care physician (PCP). The PCP is responsible for coordinating all of your care. Any referrals to a specialist must first be approved by your PCP in order to be considered a covered expense. Note: some plans also allow you to choose an OBGYN as your PCP.
A Participating Physician whose area of practice and training is family practice, general medicine, internal medicine or pediatrics, or who is otherwise designated as a Primary Care Physician (“PCP”) by Company. A PCP has agreed to provide primary care services and to coordinate and manage all Covered Services for Members who have selected such Participating Physician, if the applicable Plan requires a Primary Care Physician for maximum reimbursement of covered benefits. Referral Specific directions or instructions from a Member's PCP, in conformance with HMO's policies and procedures, that direct a Member to a Participating Provider for Medically Necessary care.
An internist (a specialist in adult care) or a family doctor who administers general care.
The network physician chosen by the HMO member to provide medical services. The PCP must provide a referral in order to see a network specialist and for network hospitals.
Term used by insurance companies to describe the provider that will manage a patient's health. In most cases this is a family practitioner, internist, general practitioner or pediatrician. The PCP is responsible for obtaining referrals to specialists as needed. Provider: General title for the physician who provides the service.
Generally refers to HMOs or other types of member organizations; the doctor selected by the enrollee is called the Primary Care Physician since that doctor is in charge of managing that member's health care needs.
a physician, the majority of whose practice is devoted to internal medicine, family/general practice and pediatrics. An obstetrician/gynecologist sometimes is considered a primary care physician, depending on coverage
A primary care physician, or PCP, is a physician who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis. A PCP generally does not specialize in the treatment of specific organ systems, such as neurology, cardiology, or pulmonology, nor perform surgery. The term "PCP" is most commonly used in the United States.