What might prolong the process of receiving homecare through an HMO?

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Receiving homecare through a Health Maintenance Organization (HMO) can involve a complex approval process that includes various checks and balances to ensure that the services provided are necessary and appropriate. Insurance follow-up investigations could significantly prolong this process. These investigations may include verifying eligibility, assessing the need for homecare services, and potentially auditing the application. When an HMO conducts such investigations, they often take additional time to ensure compliance with policies and guidelines, which can delay the start of homecare services.

Other aspects, such as miscommunication with the doctor, referral paperwork errors, or the client’s health stability, could cause delays as well; however, these are often more manageable issues that can be resolved relatively quickly. In contrast, investigations carried out by the insurance company can lead to extensive review periods due to the internal protocols and regulations that need to be followed, thus leading to a more significant delay in receiving the necessary homecare services.

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