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