Question

Harry has medical insurance through an HMO. He would like to see a podiatrist about the foot pain he has been having. What is the first step he will have to take in order to see his podiatrist?
A. schedule a visit to a specialist out-of-network
B. get a referral from his primary care physician
C. arrange a meeting with his HMO provider
D. get a hospital to diagnose his condition

Answer 1

Answer: get a referral from his primary care physician.

Explanation: An HMO is an acronym for Health Maintenance Organisation. They are intermediaries/middle men for companies and health services companies(dentist, optician, hospitals etc). Companies pay HMOs to cover the health insurance of their employees and families of their employees.

Harry has to get a referral from his primary care physician because the diagnosis has to come from them in order for his HMO to approve his visit to the podiatrist.

Answer 2

B is the correct answer. Harry will have to get a referral from the primary care physician he chose when he signed up to his HMO. His primary care physician will be able to refer him to a specialist who can offer Harry better advice than they are able to.