For a patient to receive a Medicare benefit at the referred rate, a referral letter is required before seeing a specialist or a consultant physician. If a patient sees a specialist or a consultant physician without a referral, the refund paid to the patient by Medicare will be at a much lower ‘unreferred’ rate.
Note It is the responsibility of the receptionist to advise patients if they need a new referral.
Use the following checklist for making appointments for specialists or consultant physicians:
•Each new patient should be referred either by their physician or by another specialist. Optometrists may refer to ophthalmologists, and dentists may also refer patients.
•A referral from a physician is valid for 12 months (unless otherwise specified).
•A referral from another specialist is valid for 3 months.
•If a patient makes an appointment for another consultation, check if their referral will still be current. If not, advise them to get a new referral from their physician.