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Why do you have to be referred to a specialist?
A referral, in the most basic sense, is a written order from your primary care doctor to see a specialist for a specific medical service. Referrals are required by most health insurance companies to ensure that patients are seeing the correct providers for the correct problems.
Does a doctor have to refer you to a specialist?
Typically, PPOs and EPOs do not require a referral to see a specialist. However, if you’re seeing someone who is out of your network, you’ll need an OK from your insurance provider first. HMOs, meanwhile, always require a referral from your primary care physician before you can see a specialist.
Do GPs get charged for referrals?
The payment GPs receive is not affected directly by referrals or prescribing – the costs for this are in a separate budget. If your GP decides to prescribe an expensive medicine for you they are not paying for it themselves.
How can I get my doctor to refer me to a specialist?
Requesting a Referral
- Visit Your Primary Care Physician. Your primary care physician will evaluate your concern and, if necessary, make a referral to a specialist.
- Verify Your Insurance and Referral Information. Contact your insurance company for referral requirements.
- Make an Appointment with the Specialist.
How long do GP referrals take?
This will usually be within 2 weeks but it can take longer. For urgent referrals, you’ll be contacted within 1 week. Contact the service or clinic directly for updates on your referral appointment.
What services do GPs provide?
General practitioners (GPs) treat all common medical conditions and refer patients to hospitals and other medical services for urgent and specialist treatment. They focus on the health of the whole person combining physical, psychological and social aspects of care.
What does a doctor’s referral mean?
A written order from your primary care doctor for you to see a specialist or get certain medical services. In many Health Maintenance Organizations (HMOs), you need to get a referral before you can get medical care from anyone except your primary care doctor.
How long is a referral to a specialist Good For?
A: A referral is good for 90 days from the date of issue. If a service is required beyond 90 days, a new referral must be issued by the PCP.
Why does my GP refer me to a specialist?
This is because all your medical records are held by that surgery. Your GP also generally understands your health history and treatments better than anyone else and will base any decision for a specialist referral on this knowledge.
Should I go to a general practitioner or specialist?
Patients are often confused as to whether they should go to a GP (general practitioner, or family doctor or primary care physician) when they fall ill, or if they should seek out a specialist. Patients today have lots of choices and they feel that it’s often more cost effective to go directly to the specialist.
Can I get a referral to a specialist?
However, whether you’ll get the referral depends on what your GP feels is clinically necessary in your case. If you wish to be referred to a specialist in a particular field, such as a surgeon or a gynaecologist (a specialist in the female reproductive system), you should see the GP you’re registered with.
What happens when you go to see a specialist?
Your GP may send you to see a specialist if they think specific expertise is necessary to diagnose or treat you. Your doctor can help you find a specialist. Specialists will report back to your GP, who may stay as your main contact and who coordinates your healthcare with input from specialists and other healthcare professionals as needed.