What is the primary care physician rule?

The Primary Care Physician (PCP) rule is a law in the state of Washington that requires people who have health insurance coverage to select a primary care provider for their healthcare needs. This primary care provider, typically a doctor, will be responsible for coordinating and managing a person’s healthcare, from regular check-ups to any kind of medical treatment. Typically, the insurance policy holder must choose a PCP from the list provided by their insurance carrier, and this physician will be the main point of contact for all healthcare related matters. The PCP will be responsible for referring the policy holder to any other specialists or healthcare providers needed in order to receive necessary care and treatment. The purpose of this rule is to ensure a higher quality of healthcare and to provide the patient with an advocate who is well-informed of their health background and any illnesses or chronic conditions. Furthermore, the PCP rule helps to keep insurance costs down by reducing the number of unnecessary tests and treatments, as the PCP is responsible for coordinating the care and ensuring that all services rendered are medically necessary.

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What is the primary care physician rule?

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