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Arrangements for care beyond primary care made by the patient rather than the provider. HMOs generally specify to which in-house departments or services a patient may self-refer. For example, patients may be allowed to self-refer to optometry or mental health services. For non-HMO services, patients are not allowed to self-refer if the care is to be paid by the HMO, except in emergencies.

Definition extracted with permission from American Academy of Family Physicians: Family Physicians and Managed Care

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12/7-10 AAAP