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Role of the Primary Care Physician

Provider Type

  • Physicians

The primary care physician (PCP) is responsible for providing comprehensive first contact and continuing care for their patients and supervising preventive, acute and chronic health care for those patients. This responsibility includes coordinating referrals to specialists, inpatient and skilled facilities, home health care, and similar services. Generally, PCPs are expected to understand and coordinate the total course of their patients' care. The PCP must also take into consideration input from the member regarding proposed treatment plans. In this way, the PCP serves a critical role in helping their patient obtain the highest coverage levels available under the HMO benefit program.

The PCP must maintain medical records, including records on preventive care, past medical treatment, past and current health status, and treatment plans for the future in the patient's medical record. When initiating a referral to a specialist, it is the responsibility of the referring physician to forward all pertinent information to the specialist for the referral. In order to promote continuity of care, the PCP must also have on record all treatment, examination and results performed by other physicians or clinicians, including service dates. Summaries are acceptable in lieu of complete chart notes.

Last Updated: 10/31/2019