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For those enrolled in a Medicare plan that requires a referral for specialist care, there are some basic steps leading to the issuance of the referral letter: A person’s doctor recommends a ...
People with MSAs do not need a referral from their doctor to visit a specialist. Medicare resources For more resources to help guide you through the complex world of medical insurance, visit our ...
With original Medicare, people can visit any doctor, clinic, or hospital countrywide, providing they accept Medicare payment. ... to choose a primary doctor and may not need a referral to see a ...
The member(s) are not required to use a gatekeeper or obtain a referral before seeing a specialist. In that case, the traditional benefits are applicable. If the member uses a gatekeeper, the HMO benefits are applied. However, the beneficiary cost sharing (e.g., co-payment or coinsurance) may be higher for specialist care. [3]
Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services ("DHS") if the physician (or an immediate family member) has a financial relationship with that entity.
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.