Specialist Referrals

The ReliantHealth process to getting a specialist referral:

step1
Your Primary Care Visit
Your journey begins with a comprehensive assessment by our primary care providers. They will evaluate your symptoms and medical history to determine the appropriate course of action.
step2
Specialist Approval
Your journey begins with a comprehensive assessment by our primary care providers. They will evaluate your symptoms and medical history to determine the appropriate course of action.
step3
Consultation with Specialist
Your journey begins with a comprehensive assessment by our primary care providers. They will evaluate your symptoms and medical history to determine the appropriate course of action.
step4
Follow-up and Coordination
Your journey begins with a comprehensive assessment by our primary care providers. They will evaluate your symptoms and medical history to determine the appropriate course of action.
referral
How ReliantHealth can get you to the right specialist
Specialist Referrals frequently require insurance approval. Please allow two weeks from your visit before expecting a call from your specialist office.

Collaboration with Key Specialists

  • As primary care leaders, ReliantHealth’s doctors proactively engages in conversations with specialists, hospitals, and community services. These discussions establish mutual expectations and ensure seamless transitions for our patients.

Reasons for Referral

  • When initiating a referral, we provide clear reasons for the specialist consultation. This ensures that the patient’s needs are accurately communicated.
  • Relevant clinical information, including diagnostic findings, symptoms, and medical history, accompanies the referral request.

Tracking Referral Status

  • Our practice can track the progress of referrals for you. We maintain a system to monitor each patient’s referral journey.
  • Regular follow-ups help us stay informed about appointment scheduling, specialist visits, and any necessary diagnostic tests.
  • Regular follow-ups help us stay informed about appointment scheduling, specialist visits, and any necessary diagnostic tests.

Obtaining Specialist Reports

  • After the patient sees the specialist, we diligently follow up to obtain the specialist’s report.
  • This report provides critical insights into the patient’s condition, treatment recommendations, and any necessary adjustments to the care plan.

Co-Management Agreements

  • In complex cases, we collaborate with specialists to create co-management agreements. These agreements outline shared responsibilities and ensure coordinated care.
  • We document these agreements, emphasizing continuity and patient-centeredness.

Electronic Exchange of Patient Information

  • Leveraging technology, we facilitate secure information exchange between our practice and specialists.
  • Electronic health records (EHRs) play a pivotal role in sharing relevant data, test results, and treatment plans.
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Contact Us Here for more information or to schedule an appointment for your evaluation.

Insurance Approval and Referral Process

Understanding Insurance Requirements

  • Insurance plans often require preauthorization for specialist visits.
  • When a patient requests a referral, we assess whether insurance approval is necessary.

Submitting Preauthorization Requests

  • If preauthorization is required, we promptly submit a request to the patient’s health insurance company.
  • Our goal is to streamline the process and minimize delays.

Patient Decision-Making

  • While ReliantHealth’s entire team works to facilitate the referral, the decision to see a specialist ultimately rests with the patient.
  • We educate patients about the benefits of specialist consultations, potential treatment options, and the importance of following through.

Advocacy and Verification

  • If a patient seeks a specialist referral after an emergency department (ED) visit, we verify the reasons behind their request.
  • Advocating for appropriate care, we ensure alignment with the patient’s needs and insurance guidelines.
solutions

Challenges and Solutions’

Care Fragmentation

  • Historically, primary care providers faced challenges in receiving timely information after referrals.
  • We actively address this by emphasizing communication, tracking, and collaboration.

Patient-Centered Approach

  • ReliantHealth’s commitment lies in patient well-being. We strive to minimize gaps in care and enhance the patient experience.
  • By integrating referrals seamlessly, we contribute to better health outcomes.

Remember, the ReliantHealth primary care team works tirelessly to navigate the referral process, advocate for our patients, and ensure comprehensive, coordinated care.

Contact Us Here for more information Or to schedule an appointment for your evaluation.