Forum - Questions & Answers

Feb 8th, 2013 - ALIMAC 18 

Referrals

If a patient is scheduled for an appointment and is told a referral authorization is required, and the patient fails to bring in the referral authorization, can we refuse to see the patient? If so, is it in writting any where? I have been looking all over and cannot find anything. I need everyone's help please.

Feb 8th, 2013 - youngblood 278 

re: REFERRALS

You can refuse to see any patient that has not yet established care, regardless of insurance requirements. I would think this would fall under the patient's "responsibilities" which might be outlined in your insurance contract (like paying their copay). By failing to obtain/bring the referral, they are not abiding by the terms of their plan. You could always offer to re-schedule once the patient has fulfilled *their* responsibility. And, you can call the referring physician so that they can document that 'patient was not seen by (your) doc because they did not bring the required referral'. Then, the referring doc hears it from *you* instead of some other story from the patient (happens).



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