tangman99
Active Member
Originally Posted by stdreb27
http:///forum/post/3239907
That is my understanding of it as well. The highlights being on an HMO that they're paid on an enrollment basis not a per visit basis. You need referals for everything not covered by your primary care physician. And finding a doctor can be difficult, since they're not profitable.
You are correct Sir! Let me very clear if you have an HMO. They are ok if you are relatively healthy but if you ever feel your doctor is neglecting something and you are covered by and HMO, listen to your insticts. If you ask for a referral and they refuse to give you one, ask them to explain why and let them know that you understand how the system works around HMO and referrals. Most doctors will do more for you if they know that you know how the HMO system works. Keep two important facts in mine (again unless they have changed).
1. They are paid by the number of members that they are a primary physician
2. They get penalized for too many referrals.
Honestly, people have died because they had an HMO. All it takes if for one physician to not refer somemone and they fail to get a test that if received timely could have saved their life. I'm not saying all HMO doctor's are like this but if you know what to look for, it won't take but once or twice for you to recognized them.
http:///forum/post/3239907
That is my understanding of it as well. The highlights being on an HMO that they're paid on an enrollment basis not a per visit basis. You need referals for everything not covered by your primary care physician. And finding a doctor can be difficult, since they're not profitable.
You are correct Sir! Let me very clear if you have an HMO. They are ok if you are relatively healthy but if you ever feel your doctor is neglecting something and you are covered by and HMO, listen to your insticts. If you ask for a referral and they refuse to give you one, ask them to explain why and let them know that you understand how the system works around HMO and referrals. Most doctors will do more for you if they know that you know how the HMO system works. Keep two important facts in mine (again unless they have changed).
1. They are paid by the number of members that they are a primary physician
2. They get penalized for too many referrals.
Honestly, people have died because they had an HMO. All it takes if for one physician to not refer somemone and they fail to get a test that if received timely could have saved their life. I'm not saying all HMO doctor's are like this but if you know what to look for, it won't take but once or twice for you to recognized them.
