Get Referral Information

Please have the following patient information available in order to quickly expedite your referral request: Full name (including maiden name, if known) Date of birth, social security number, or DHMC medical record number. Current address.

A consultation is a rendering of advice or professional opinion, followed by a report of findings to the referring physician. A referral on the other hand is simply a request to assume care of a patient. In order to bill for a consult, it is essential for that to be supported in the medical record.

Referral: The recommendation of a medical or paramedical professional. ... The referral is obtained from your PCP, who may require a telephone or office consultation first. The term "referral" can refer both to the act of sending you to another doctor or therapist, and to the actual paper authorizing your visit.

How Referrals Work With Your Health Insurance. A referral is a special kind of pre-approval that individual health plan members primarily those with HMOs and POS plans must obtain from their chosen primary care physician before seeing a specialist or another doctor within the same network.

In order to see a specialist, you'll need a referral from your primary care physician, except in an emergency. Without a referral, your insurance won't cover the cost of your care.

Referral. 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.

A referral management system is a unique and powerful tool for health providers to keep track of their patient referrals throughout the care continuum. Its main goal is to improve and streamline communication among primary care physicians, specialists, and health providers involved in a patient's care.

Medical Definition of referral 1 : the process of directing or redirecting (as a medical case or a patient) to an appropriate specialist or agency for definitive treatment. 2 : an individual that is referred.

Referrals, simply defined, are contacts that are initiated by the nurse and other members of the healthcare team in order to meet the needs of the client at the appropriate level of care and in the appropriate setting. Registered nurses manage and coordinate care along the continuum of care.

A referral is issued by the primary care physician, who sends the patient to another healthcare provider for treatment or tests. A prior authorization is issued by the payer, giving the provider the go-ahead to perform the necessary service.

Are Referral Fees Legal? ... Federal law makes it illegal for referring doctors to receive fees from medical testing centers for referring patients or for interpreting medical test results. Doctors cannot refer their Medicare or Medicaid patients to medical labs that the doctor or his immediate family own.

Physicians may insist they will only do what's best for patients, regardless of payment for referrals. ... Menzel says that before the kickback incidents were widely reported, most patients probably never even considered their physician might get some type of incentive for a referral.

Physician-to-physician referrals are the currency of day-to-day transactions in medicine, but as with any currency, they can be manipulated. Logic says that a referral should depend only on a patient's needs and the reputation and skill of the physician to which the patient is referred.

A physician may refuse a referral for a variety of reasons but not if he or she has a preexisting duty to care for the patient. ... This may be on a patient-by-patient basis or through an ongoing agreement. If the receiving physician refuses to accept the patient, the referring physician must make other arrangements.

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. ... Make an Appointment with the Specialist.