Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Financing Health Care - Part 1
Lecture:Payors in the U.S. Health Care System
Slide content:Point of Service Plan (POS) Gatekeeper All services through primary care physician Controls access to all medical services Referrals generally to in-network providers only May refer out-of-network No reimbursement for services to out-of-network providers unless previously authorized by gatekeeper 19
Slide notes:The point of service plan, or POS, includes a primary care physician, or gatekeeper, who controls access to plan-only providers, similar to an HMO. The primary care physician becomes the point of service for delivery of all health care services. In a POS plan, referrals can be made out of network at the discretion of the primary care physician. 19