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HMOs Unique Features And Lingo

Primary Care Physician (also known as "PCP" or "Gatekeeper")

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The Primary Care Physician, also known as a "PCP" or as the "Gatekeeper," is the member point of entry to the HMO health care system. 

The PCP:

  • Is generally a doctor but can also be a Nurse Practitioner or Physician's Assistant.
  • Sees members for routine matters and provides the primary level of care.
  • Decides when and if a member should see another provider such as a specialist.
  • Decides when and what tests should be performed.
  • Decides when a member should be hospitalized.

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