What is the primary care physician rule?

The primary care physician (PCP) rule is a law in North Carolina that outlines the rules and regulations for how health insurance works in the state. It is designed to ensure that patients have access to quality healthcare and that insurance companies are not overcharging patients for medical services. Under the PCP rule, patients are required to choose a single PCP to coordinate all of their health care needs. This physician will serve as the patient’s primary care provider and will be responsible for providing all of the patient’s necessary medical care. This physician must be approved by the patient’s insurance company and must be in-network with the patient’s plan. The PCP is responsible for overseeing the patient’s care, referring them to specialists when needed, and providing preventive care services. This rule also requires that, before a patient is referred to a specialist, they must receive a referral from their PCP. The PCP must also provide authorization for the specialist before the patient can receive treatment. The intent of the PCP rule is to help ensure that patients receive the best quality healthcare at an affordable price. By requiring patients to choose one physician to oversee their care, the PCP rule allows for better coordination of care and prevents unnecessary referrals and duplicative services. This helps to keep costs down and helps ensure that patients have access to quality care.

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What is the primary care physician rule?

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