A primary care provider (PCP) is considered your mainmedical provider.
Depending on thetype of health insuranceyou have, your health plan may require you to have a PCP.
Several types of medical providers can serve as your PCP, depending on your needs.
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This may include a surgeon, a psychiatrist, or acardiologist, for example.
They will help you determine any medical concerns youre at risk of developing in the future.
Youll also go to your PCP for non-emergency problems that arise unexpectedly.
Did you tweak your back while giving your dog a bath?
Your PCPs office should be your first stop.
Managing Chronic Conditions
Yourprimary careprovider is also good at managing most chronic medical problems.
In some cases, your PCP may work together with a specialist to manage chronic medical problems.
Takerheumatoid arthritisas an example.
Arheumatologistmay be involved in the initial diagnosis and treatment of the disease.
But they may turn routine care over to your PCP once the disease is well controlled by medications.
Your PCP will then follow up on routine blood tests and prescription refills.
In these situations, your PCP is the key member of your healthcare team.
Quite often, they are your primary contact who can help guide you along the way.
PCPs are experts at coordinating care.
If youre healthy, this wont mean much to you.
In the role of care coordinator, your PCP is the team captain.
Your insurance company will also do this as part of theirutilization review.
But having your PCP coordinating it will help to avoid denied insurance claims and needless medical services.
Do you have 20 active prescriptions from different specialists?
Your PCP makes sure theyre all necessary and compatible with each other.
(Your pharmacists can also help with this, especially if you usethe same pharmacyfor all your medications.)
Recently hospitalized for heart problems and now ready to start cardiac rehab?
PAs and NPs usually practice under the supervision of a physician and are known as mid-level providers orphysician extenders.
And referrals from an OB/GYN must be treated as acceptable in terms ofspecialist referralsrequired by managed care plans.
With these rules, the ACA allows a woman the option to select an OB/GYN as her PCP.
If your health plan assigns you a PCP, you still have the option to pick a different PCP.
As a general rule, carefully read your own plan’s details and rules.
Having a primary care provider is an important part of keeping yourself healthy in the long run.
They also understand youre not a hypochondriac or just looking for narcotics, which can be very helpful.
Summary
A primary care provider can offer a range of general/routine medical care.
These same health plans often require a referral from a PCP so you can see a specialist.
Establishing a relationship with a PCP can go a long way toward keeping you healthy.
They can provide a variety of routine medical needs and will come to know you over time.
Medline Plus.Choosing a primary care provider.
Department of Health and Human Services,Text of the Affordable Care Act.
2719A [42 U.S.C.
(d) PATIENT ACCESS TO OBSTETRICAL AND GYNECOLOGICAL CARE.
