If a patient has managed care insurance, who is the usual gatekeeper to authorize consultations with specialists?

Question

Quizplus · Accepted Answer

The primary care provider is typically the gatekeeper in managed care insurance plans, responsible for authorizing consultations with specialists. They serve as the first point of contact for patients and work to coordinate their care. The referral coordinator may assist in the process, but the decision ultimately lies with the primary care provider. The nurse practitioner may also be involved in the patient's care, but may not have the authority to authorize specialist consultations on their own. Employees at the managed care insurance company may provide information and support, but do not typically authorize or deny medical services.

If a Patient Has Managed Care Insurance, Who Is the Usual