There are various reasons you may need to see a specialist after an acute or urgent medical illness or condition. The good news is that State Urgent Care can refer you to a specialist during your visit to be seen for both short and long-term care and recovery.
Understanding the referral process is essential in helping you determine whether you may require a referral and how urgent care can help you obtain one. Learn more below.
What is a referral?
A specialist referral is a written order to a doctor specializing in a particular medical area. It is typically written by your primary care provider.
In the instance that you require urgent or life-saving medical care immediately, an emergency room physician or urgent care provider may write a specialist referral for you after your visit or stay at urgent care or the hospital.
Referrals are a direct order processed through your insurance company to confirm that you require additional treatment outside of the scope of primary care.
How do I know if I need a referral to see a specialist?
Most insurance companies require a referral before seeing a specialist, but the exact requirements are based on your specific insurance coverage.
In most cases, HMO and POS plans require referrals before specialist visits, while PPO and EPO plans do not.
It is best to always review the exact requirements of your insurance provider by calling the phone number located on your insurance card.
What happens if I don’t get a referral?
Although referrals are not mandated for specialist treatment, they are the most cost-effective option for those who have medical insurance. Without a referral, the patient could be responsible for up to 100% of the cost for medical treatment at the specialist. Instead of paying a standard copay, you would be responsible for the entire balance from your specialist visits after treatment.
Conversely, with a referral, you are typically only responsible for a copay and, possibly, a portion of the cost of your insurance deductible has not yet been met for the year.
Does all treatment at urgent care require a specialist visit?
No, not all treatment requires a visit to a specialist after your urgent care visit. In fact, many illnesses and conditions can be successfully treated at State Urgent Care without the need for follow-up care or treatment.
What illnesses and injuries require a specialist visit?
Each patient’s diagnosis is unique, so it is hard to determine precisely how many urgent care visits result in specialist referrals. Still, some common issues often require a specialist visit, including:
- Severe allergies
- Heart trouble
- Broken or fractured bones
- Skin conditions
- Sprains and strains
If you are experiencing acute or urgent medical issues, you should be seen today. Our experienced medical specialists at State Urgent Care are trained to help you with a variety of healthcare services. We will create a treatment plan that works for your personalized needs, even if it includes a specialist referral.
We are open 7 days a week with no appointment necessary. Call us now to learn more at 662-780-1981 or just walk in today.