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    • 12
      Mar
    • (0)
    • By Pete Crutchley


    • Medical Billing News

    Open Referral – What are the benefits to consultant surgeons again?

    Mar 12 - Open Referal

    I took a phone call from a friend recently who works for one of the major insurance providers. He asked why I was still against the principal of open referral. The benefits for both patients and consultants were obvious in his view.

    Without being obtuse, I disagree. Firstly because the question of benefits is being looked at from the wrong angle. Secondly, because it depends on who is “selling” such benefits?

    His reply was the standard – the benefits are applicable to patients and are twofold. Firstly, he /she has a choice of private consultant. Secondly, it’s cheaper and this is reflected in the policy premium.

    Maybe. But in my experience, I’ve seen and heard slightly different. I’ve spoken to patients who made an appointment with THEIR consultant of choice only to be told by the insurance company they should see another consultant instead i.e. one NOT of their choice. And I’ve not heard of anyone having his or her policy premium reduced because they saw a different consultant.

    I’m uncomfortable with a patient calling an insurance company and being recommended to change consultant based on the insurance company’s experience. I’m even more uncomfortable if cost enters into the equation.

    Open referral – no sale. Sorry.

    E-mail me if you have a different view.

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