The Elizabethan Health Plan uses a direct referral program, which means that
A) PCPs in Elizabethan's network can make most referrals without obtaining prior authorization from Elizabethan
B) PCPs in Elizabethan's network must always refer plan members to other specialists within the network
C) Elizabethan's plan members can bypass the PCP and obtain medical services from a specialist without a referral 53
D) Elizabethan's plan members must obtain referrals directly from Elizabethan

Question

Quizplus · Accepted Answer

The passage states that Elizabethan Health Plan uses a direct referral program, and that PCPs in the network "can make most referrals without obtaining prior authorization from Elizabethan." This suggests that PCPs have the ability to refer plan members to other specialists without needing to go through Elizabethan for approval, making option A the correct choice. Option B is incorrect because it is too restrictive; the passage does not suggest that plan members must always be referred within the network. Option C is incorrect because it contradicts the direct referral program described in the passage. Option D is also incorrect because it suggests that plan members must obtain referrals from Elizabethan directly, whereas the passage indicates that PCPs can make most referrals without going through Elizabethan.

The Elizabethan Health Plan Uses a Direct Referral Program, Which