[M009]

managing physician

In an HMO or PPO, the managing physician is also called the primary physician or the primary health care provider. He/she is the program-approved physician whom the insured must consult first for all medical needs. The managing or primary physician will handle all medical needs and services that fall within that person's own area of expertise. If additional services or specialists are needed that are outside the primary care physician's area, he/she must concur the need and approve such additional services or specialists in order for coverage to be in effect for those additional costs.