Primary Care Physician

Definition

  • A physician who is responsible for the bulk of a individual's health care, personally treating routine and remedial health conditions and setting up referrals for those outside their expertise. If the patient is a member of a health maintenance organization (HMO), the primary care physician will act as a gatekeeper and only prescribe treatments covered by the HMO.

Synonyms
primary doctor, primary physician

Related Terms and Acronyms

  • Case Management Definition,
    • A system where medical services and patient treatments are coordinated by a case manager.
  • Disease Management (DM) Acronym, Important,
    • The process of discussing and agreeing to treatments and care plans for individuals with long-term health care needs.
    Heath care decisions made to manage a disease.
  • Gatekeeper Definition,
    • In relation to health maintenance organizations, a gatekeeper is a primary care physician that arranges medical care for policyholders.
  • Health Insurance (HI) Acronym,
    • Insurance that covers the costs of medical expenses for insured persons.
  • Health Maintenance Organization (HMO) Acronym, Important,
    • A healthcare plan where insured people receive reasonably priced health insurance through an organization with firm guidelines on the scope of care.
  • Least Expensive Alternative Treatment (LEAT) Acronym,
    • When multiple treatment options exist for the same illness, insurers are only obligated to provide the most cost effective treatment.
  • Medical Specialist Definition,
    • A doctor with training in a specific medical field.
  • Point of Service Plan Definition,
    • A health insurance plan that combines the features of both health maintenance organizations and preferred provider organizations.
  • Preferred Provider Organization (PPO) Acronym,
    • A health care program that gives its members a level of freedom and independence when choosing health care options.
  • Usual, Customary and Reasonable Fees Definition,
    • The expected cost of a medical treatment, and what an insurance company is willing to pay.
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