A term describing a member's ability to self-refer for specialty care. Open access arrangements allow a member to see a participating provider without a referral from another doctor. Health plan members' abilities, rights or invitation to self refer for specialty care. Also called Open Access.
A type of health plan other than a closed panel plan that provides incentives for the enrollee to use providers selected by the plan.
A right included in an HMO which allows the covered person to obtain non-emergency covered services from a specialist without a referral from the primary care physician or gate keeper.
A feature of a health plan that offers a variety of types of treatment providers that subscribers can use for their health care without overly restrictive liability.
A managed care plan that contracts (either directly or indirectly) with private physicians to deliver care in their own offices. Examples would include a direct contract HMO and an IPA.
A right included in an health maintenance organization (HMO) plan that allows the covered person to obtain non-emergency services from a specialist without a referral from the primary care physician or gatekeeper.
Allows a participant to see another participating provider of services without a referral. Also called open panel. (H)