Why do Specialists and Doctors require a referral?

  • August 4, 2020
  • 4 min
Why do I need a referral to see the Specialist

Visiting your General Practitioner to get a medical referral letter is common practice before seeing a specialist. It is a vital step that ensures your eligibility for a Medicare rebate and connects your specialist and GP to ensure you are surrounded by an expert medical team.

There are numerous reasons why specialists require a referral, including:

  • Your GP will ensure you are visiting the correct type of specialist.
  • Your GP remains involved in your ongoing care.
  • The specialist is aware of your medical history and current circumstances as outlined by your GP.
  • Required for Medicare rebate.

How do I get a medical referral letter from my GP?

It may seem like a hassle having to visit your GP before you can visit a specialist. You book the appointment, wait for a long time and then leave the Doctor’s room after five minutes with the letter in your hand. While this extra step may seem pointless or frustrating, there are numerous benefits of visiting your GP first.

GP’s offer a comprehensive range of healthcare services and may be able to assist you without a specialist visit. They are also trained to identify when patients require specialist diagnosis or treatment and can therefore refer patients to visit a specific medical specialist.

Another benefit of visiting your GP before the specialist is that they can assess your health condition and ensure you are visiting the correct type of specialist. Particularly if you have known your GP for some time, they will be aware of your medical history and can communicate this to the specialist.

If you have a health concern but are unsure of its diagnosis, a GP will assess your condition, provide treatment, or refer you to the appropriate care.

How is Medicare involved in the referral process?

There are referral rules which must be followed for Medicare to provide a rebate. To receive financial assistance via Medicare, the GP and patient must adhere to the referral guidelines.

This does not mean that Medicare is guaranteed to cover all or some of your specialist treatment. Your GP can provide further guidance into the eligibility of Medicare for your unique circumstances.

Can my GP backdate my referral letter after I see the specialist?

Your referral letter must be dated on or before the date you visit a specialist. General Practitioners are unable to backdate a specialist referral letter. Moreover, most specialists require the patient to have a referral letter before making an appointment.

How long does a referral letter remain valid?

When a GP refers you to a specialist, the referral is valid for 12 months. A referral between specialists, however, is only valid for 3 months.

For patients with an ongoing health condition, your GP can arrange an indefinite referral which permits you to visit your specialist without requiring annual renewal.

Who decides which Specialist I can visit? Me or my GP?

GP’s often refer their patients to a specialist before the patient has an opportunity to investigate the specialists available in their area. The expertise and experience of your GP should be highly regarded, but what if they refer a specialist who is booked out months in advance? What if they refer you to a specialist who is 50 minutes away from home when you have heard great reviews about a specialist 15 minutes away?

Smart Referral provides patients with a choice. By simply uploading your referral letter, you can access information about the relevant specialists in your area, how much they charge and know their appointment availability before booking.

The referral process, while time-consuming, has multiple benefits to ultimately help the patient. When you need to visit a specialist, upload your medical referral letter to Smart Referral, and have a choice in the practitioner you visit.

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