What's The Deal With Referrals?

When you want to see a specialist, most insurance carriers require that you first get a referral from your Primary Care Physician (PCP). Why? Insurance companies don't want people self-referring to specialists for something that might not require that level of attention. In our current day in age of WebMD as a major resource, this is basically an additional step to ensure that a medical professional agrees that you require a specialist's care.

Now, let's say you twist your ankle. Most people would know that this type of injury requires a visit with an orthopedist. What you’ll do first, however, is likely visit an urgent care facility to have x-rays. Once determined that there isn’t a medical emergency, (you know the drill) - you'll be sent to your PCP for a referral to see an orthopedist rather than going directly to the orthopedist. Again, you may ask yourself…why? Well, many insurances don't pay for direct access visits without the screen of a PCP. Luckily, it is possible to skip this step and see a specialist through UBERDOC without requiring a referral from your PCP.

If you’re thinking to yourself, “Referrals can be complicated,” you’re correct! They take up a lot of your time and a lot of time on the behalf of the administrative team at your doctor's office. They’re actually required to call the specialist and get all kinds of provider numbers, and then submit the referral using authorization codes. If just one number is off, the referral may fail and the administration must take the time again to resubmit. Then, after the code is submitted, it takes some time for the referral to come back approved. For example, the referral won't be approved if the specialist you want to see is out-of-network with your insurance company, (aka you're choosing from a smaller pool of qualified medical specialists when getting a referral.) And THEN, after all that, you can finally book the appointment with the specialist, hopefully feeling confident that your insurance will (fingers crossed) cover the visit. But we all know there are times that the insurance company still won't cover that visit even though we thought we did all the things we were supposed to do as good, responsible patients!

UBERDOC saves the time of the office staff at your PCP's office and it saves you from having to go through all that hassle of potentially taking multiple days off of work and paying multiple co-pays to see a specialist who may then have a 54 day wait time (which is the average wait time to see a specialist in the US). So, skip the referral process. Save yourself and the staff at your doctor's office the hassle and book directly on UBERDOC!

Schedule your appointment with a specialist today! Or, follow UBERDOC on Facebook and Twitter.

Ellen Bunn, PT, CPT, CI
UBERDOC