Question: What Happens When You Are Referred By Your GP To See A Specialist?

What happens when you are referred to a specialist?

The specialist will discuss with you whether you should attend hospital for ongoing follow-up care or whether you should be discharged back to your GP.

If the specialist thinks you do need to be seen again, the hospital will give you another appointment or tell you when to expect this..

Can I see a specialist without a referral?

2 If you do not have a referral from your primary care physician, your HMO likely will not cover the service at all. But some modern HMOs have relaxed these rules and now allow members to visit specialists within the plan’s network without having a referral from their primary care physician.

Can you see a private consultant without a GP referral?

No, it’s possible to seek private treatment from a consultant or specialist without being referred by your GP. However, the British Medical Association (BMA) believes that, in most cases, it’s best practice for patients to be referred for specialist treatment by their GP.

How do I know if I need a referral?

When you are covered under an HMO plan and need to have a service performed by someone other than your primary care provider (PCP) your provider will need to submit a referral request. … PPO plans do not require a referral before having a service performed; even if you’re going to a specialist.

Can you ask your GP to refer you to a specialist?

You’re entitled to ask for a referral for specialist treatment on the NHS. However, whether you’ll get the referral depends on what your GP feels is clinically necessary in your case.

Why do you have to be referred to a specialist?

The referral covers the assessment and ongoing management of a particular problem by the specialist. If over time, the specialist needs to continue to see you on an ongoing basis to manage a specific problem, an indefinite referral may be possible.

Can you self refer to a specialist?

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.

Do doctors get paid for referrals to specialists?

Anti-kickback laws keep doctors from paying other doctors directly for referrals. But in an effort to ensure hospitals, doctors’ groups and other health providers better coordinate patient care, the Affordable Care Act makes allowances for keeping it in the medical family, so to speak.

How do I get referred to a specialist?

Follow the steps below when 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. … Make an Appointment with the Specialist.

Who is responsible for getting a referral?

If it is necessary for the patient to see a specialist, other than for direct access services of emergency care, the primary care physician must issue a referral prior to the patient’s visit to the specialist. The referral must be for covered benefits under the plan.

How long does a specialist referral last?

Referral periods A referral from a medical practitioner to a specialist lasts 12 months, unless noted otherwise. The referral starts from the date the specialist first attends the patient, not the date issued. If your patient needs continuing care, you can write a referral beyond 12 months or for an indefinite period.

Why would I be referred to a gynecologist?

A visit to the gynecologist is recommended for annual screening and any time a woman has concerns about symptoms such as pelvic, vulvar, and vaginal pain or abnormal bleeding from the uterus. Conditions commonly treated by gynecologists include: issues relating to pregnancy, fertility, menstruation, and menopause.

Can a dentist refer you to a specialist?

A general dentist, making a recommendation for referral to a specialist, should do so on the basis of what is ‘appropriate and best for the patient’, in the context of their own level or constraints of experience, expertise and training.

Does a doctor have to refer you to a specialist?

Most health plans do not require patients to get a referral from their PCP to obtain specialist care. This makes it even more imperative for a strong physician-patient relationship in which the PCP can guide patients towards the best treatment and specialty care, when needed.