Illinois Health Insurance Practice Exam 2025 – 400 Free Practice Questions to Pass the Exam

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What is the main function of a primary care physician (PCP) in a managed care plan?

Provides emergency care exclusively

Coordinates patient care and referrals to specialists

The main function of a primary care physician (PCP) in a managed care plan is to coordinate patient care and referrals to specialists. PCPs serve as the first point of contact for patients seeking medical attention and are responsible for managing their overall health. This includes conducting routine check-ups, diagnosing and treating various health conditions, and guiding patients through the healthcare system.

In a managed care model, the PCP plays a crucial role in ensuring that patients receive appropriate care while controlling costs. By coordinating referrals to specialists and other healthcare services, the PCP helps streamline patient care, ensuring that treatments are both necessary and effective. This system not only enhances patient outcomes by providing comprehensive management of health concerns but also prevents unnecessary specialist visits and tests, which can lead to higher healthcare expenditures.

Other options do not represent the primary functions of a PCP accurately. For instance, a PCP does not provide emergency care exclusively as that falls primarily to emergency care physicians. Acting as an insurance agent is not a function of a PCP; they focus on patient health rather than administrative insurance tasks. Lastly, while prescribing medications is part of a PCP's role, it is not their only function, nor does it encapsulate their primary responsibilities within a managed care context.

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Acts as an insurance agent for patients

Only prescribes medications

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