Getting A Specialist Referral: All You Need To Know
While general practitioners, commonly known as GPs, can assist with various health issues, certain conditions require the consultation of a specialist doctor. But when you’ve just received a Medicare specialist referral for the very first time, several questions can come to mind. Here are the answers to some of them:
Who is a specialist?
Simply, a specialist is a doctor who has specialised in a specific area of medicine and might provide more specialised care. These include endocrinologists, cardiologists, dermatologists, hematologists, neurologists, obstetricians, pediatricians and more. Most of these specialisations require an extra three to seven years of training after medical school.
What is a referral?
While a GP is generally the first person you see for any medical ailment, you may sometimes need the expertise of a specialist for a diagnosis or treatment. In such a case, your GP will write a letter to a specialist, which typically includes the medical reason why you are being referred to a specialist, your medical history, the medication you’re currently on as well as any allergies you may have.
The referral will also include the date of the referral and the signature of the referring practitioner. You may ask your GP to recommend someone, or you may choose the specialist you want to be referred to.
Does Medicare cover a specialist consultation?
Medicare covers 85% of the Medicare Benefits Schedule (MBS) fee for a specialist visit. However, many specialists charge above the standard MBS fee, so it is worthwhile to contact the specialist before your appointment and find out how you will be charged for the consultation.
Can I see a specialist without a GP referral?
While most specialists do see patients without referrals, many do not. More importantly, to get a Medicare rebate on your specialist consultation, it is essential to have a referral as Medicare does not cover any costs for a specialist consultation without a referral.
How long does a referral last?
How long your referral lasts depends upon who writes it. Most referral letters written by GPs are valid for 12 months, but referrals from specialists to other specialists are only good for 3 months. However, if you suffer from a chronic condition and need to see a specialist for longer than 12 months, your GP can write a referral for longer than 12 months or even for an indefinite period. However, if your condition changes or a new condition emerges, a new referral will be needed to treat the second condition.
Can I backdate my referral?
No. Backdating is a legal offence, and the issuing doctor may have to face charges and penalties for backdating a referral. Additionally, Medicare will not cover any costs of a backdated referral. Backdating refers to seeking a referral from a GP after you’ve already seen the specialist, often used as a way to claim Medicare payments.
Can I get a specialist referral online?
Certainly! Similar to a traditional referral, an online referral at Prime Medic works the same way. Except, instead of getting an appointment at your GP’s office and driving down to what is likely to be a 5-minute consultation, you get to do it from the comfort of your own home. Just follow the six easy steps and get your specialist referral to claim Medicare benefits without exposing yourself to illness in the waiting room!
The six steps are:1. Select referral
2. Select medical condition
3. Fill questionnaire
4. Select specialist
5. Pay fees
6. Get your referral!
