Primary care physicians refer their patients to specialists for consultations
A primary care physician, also known as a family doctor, provides general care for patients of all ages. Specialists focus on one specific area in health care, such as cardiology or neurology. Primary care physicians may suspect a health problem that requires in-depth treatment and care that they are unable to provide. A patient's family doctor will recommend or refer the patient to a specialist. Referral protocols can be used to determine how, when and why physicians will recommend a specialist consult for their patients.
Determine Need for a Specialist
Referral protocols should include information regarding how and when to refer a patient to a specialist. Guidelines for the conditions that require a specialist can be laid out in detail within the protocol. Methods regarding tell patients they may have a condition that requires a specialist can be outlined in the protocol. The referral protocol can also state whether the primary care physician's office will arrange with the specialist or if it will be up to the patient to arrange an appointment as well as any testing that may be required prior to the appointment.
Work With Insurance Companies
Include the preferred method each insurance company accepted by the physician's office has for recommending specialists to patients. Some insurance companies may require pre-approval for referral services. Place a special notation next to the names of the insurance companies that need pre-approval prior to making arrangements with a specialist. Notations can also be placed next to the names of the insurance companies that do not require special procedures for referrals. A list of specialists covered by each insurance company may be added to the protocols if desired.
Choose the Appropriate Specialist
The referral protocol may include choose the specialist to which the patient will be referred. The area where the specialist is located, the hospital where the specialist works and whether or not the specialist is accepting new patients are all considerations that must be made when choosing the appropriate specialist. Reminders of these considerations can be added to the referral protocol to assure the primary care physician keeps them in mind when recommending a specialist to his patients. Systematic instructions about arrange with a specialty physician's office can be included within the protocol.
Tags: care physician, insurance companies, physician office, primary care, primary care physician, referral protocol, arrange with
