Managing Director
of Synapse Medical
Services.
slide. Typically, about 15 minutes into our
presentations for The Private Practice, Steven
Macarounas is forced to politely interject
to end the barrage of questions from the
specialists in the room. The questions tend
to run along the same lines:
can we simply circle the name of
the doctor or `fill in the blank'?
who have been referred to him by their GP
to me, as they can get in to see me quicker.
Is it okay for me to `take over' the referral?
person at 4am for a new problem (Y),
can I bill an initial assessment 110
(though technically there is no referring
doctor for the Y problem) because the
patient is already under my care?
start another `period' with a 110,
new referring doctor, or just continue
with the 116 because one is basically
continuing care for the same problem?
achieve this when Medicare requires that
referrals name the individual doctor?
the case. Indeed, it's a topic that is neither well
understood nor easily or briefly explained,
yet referrals are an important and deeply
embedded component of our national health
scheme. So, let me answer those questions.
can be found in section 20BA of the Health
Insurance Act 1973,andregulations29,30
and31oftheHealth Insurance Regulations
1975 neither of which provide absolute
clarity as to whether a referral must be to a
named specialist or not, and this is the cause
of much of the confusion. But it's not so
much what the legislation says, it's what it
doesn't say that provides some answers.
rather than practices, and uses the singular
rather than plural. This is seen in the use
of phrases such as:
or specialist'
`a patient is to be referred by a referring
practitioner to another practitioner'
`in the practice of his or her specialty'
audit? In the interest of clearing up your concerns,