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Frustration: Access to Outpatient Ostomy Care in the HMO Environment

Online Exclusives

Frustration: Access to Outpatient Ostomy Care in the HMO Environment

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This online exclusive will feature a variety of topics on care management — from unique case studies that offer useful information about hard-to-treat cases to the challenges of reimbursement. Your contributions and comments are welcome. Send email to The Editor: bzeiger@hmpcommunications.com.   For those of us lucky enough to have health insurance coverage, we pay our premiums or a portion of the premium on a monthly basis and access the healthcare system as necessary. The premium amounts are usually substantial, especially with the recent fee increases from many of the insurers. In return for these substantial fees, we expect to have access to and receive appropriate healthcare services.   On more than one occasion, I have received inquiries about providing ostomy care for a patient who is covered by some type of HMO insurance plan. In general, this does not appear to pose a problem; however, if there are no ostomy services available in an outpatient setting where all HMO member patients can access regardless of their