Why wouldn’t a managed indemnity plan collect referral data?
A managed indemnity plan is a type of health insurance plan in which the insurance company provides a fixed amount of reimbursement for covered medical services, regardless of which healthcare provider you choose. Unlike traditional managed care plans (such as HMOs or PPOs), managed indemnity plans typically do not require referrals from primary care physicians to see specialists.
Referral data is typically collected in managed care plans to track patient movement within the healthcare system. In these plans, primary care physicians serve as gatekeepers and play a significant role in coordinating and managing their patients' healthcare by referring them to specialist providers when necessary.
However, since managed indemnity plans do not require referrals, there is no need to collect referral data. With these plans, policyholders have the freedom to see any healthcare provider without obtaining a referral first. This adds flexibility and eliminates the need for collecting and monitoring referral data.
It's important to note that while managed indemnity plans offer more freedom of choice, they may also require policyholders to pay higher out-of-pocket costs or meet deductibles before coverage kicks in. It's advisable to review the terms and conditions of your specific plan to fully understand its coverage and requirements.