Precertification make difference in the payment

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Jesse belongs to an HMO that requires precertification and preauthorization for certain medical care. Jesse does not like any of the physicians in the HMO, so he decides to go to a physician out of the network. When he receives his bill for care, his insurance has only made a minimal payment, and he is responsible for a substantial portion of the bill. What did Jesse do that minimized the payment? Would preauthorization or precertification make a difference in the payment?

Reference no: EM133541177

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