HMO in Medical Billing
HMO stands for Health Maintenance Organization, a type of health insurance plan that requires members to receive care from a network of designated providers.
HMO in Medical Billing Explained
In medical billing, HMO plans limit patient access to a network of providers and often require referrals from a primary care physician for specialist services. Providers must follow specific HMO guidelines for billing and reimbursement.
For example, a patient with an HMO plan needs a referral from their primary care doctor before seeing a specialist, and the provider bills the HMO for approved services.
See common acronyms and abbreviations in Medical billing glossary.
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