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In medicine, referral is the transfer of care for a patient from one clinician or clinic to another by request. [ 1 ] [ 2 ] Tertiary care is usually done by referral from primary or secondary medical care personnel.
Electronic referrals can result in considerable benefits for service providers. Firstly at the patient level, e-referrals ensure significant improvements to follow-up care coordination [4] by the creation of accurate and timely referrals. Medical decisions are enhanced as each provider involved has the full patient information available to them ...
Unlike PPOs, however, HMOs often require members to select a primary care physician (PCP), a doctor who acts as a gatekeeper to direct access to non-emergency medical services, and are required to first obtain a referral from their PCP in order to be reimbursed for the cost of medical services inside of their network of designated doctors and ...
The earliest form of HMOs can be seen in a number of "prepaid health plans". In 1910, the Western Clinic in Tacoma, Washington offered lumber mill owners and their employees certain medical services from its providers for a premium of $0.50 per member per month. This is considered by some to be the first example of an HMO.
Tricare for Life is designed to pay patient liability after Medicare payments. There is no enrollment necessary for Tricare for Life and to be eligible, members must be Tricare and Medicare Eligible and have purchased Medicare Part B coverage. An exception to the requirement for Part B coverage exists when the beneficiary that is Medicare ...
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