We've all been there...

We’ve all been there…sitting anxiously in our PCP’s office waiting for the result of some routine tests. As the doctor comes back with the results, you hope he or she is going to say, “you’re good to go,” but instead they tell you those five dreadful words: “you should see a specialist.” The doctor likely then hands you a barely legible script sheet – if you are lucky, the script sheet includes the names of a few potential specialists – and before you have a second to think of any pressing questions, the doctor walks out of your appointment.

Now, you are now tasked with finding a specialist, something your PCP’s office probably doesn’t help you with. If your PCP does give you a list of a few potential specialists, he or she has no idea if those specialists take your insurance or have availability. As a result, the onus is on you to find and book yourself a specialist appointment.

So, you likely find yourself at home searching the internet or your insurers’ website for the right specialist and wondering to yourself why your doctor, the medical expert, couldn’t have set up this appointment on your behalf. As you start your specialist search, there a number of factors you need consider.

First, you need to make sure you are searching for the right type of specialist. You need someone for pain management, but everyone you find when you search for pain management is an anesthesiologist. Can an anesthesiologist help you with you back pain?

Second, you need to find a specialist that takes your insurance. You look at your insurance portal, but it doesn’t tell if you if the doctor has any availability in the next few days, and your back is killing you, so you want to be seen immediately! Now you begin the fun game of calling a handful of specialists on the list to see who has the soonest availability. After calling, sitting on hold, giving all your information, sitting on hold again, you cross your fingers and hope that this specialist has availability because you just spent thirty minutes of your life on hold with the admin, time that you can’t get back.

If the specialist does have availability, you have to consider all of the other intangible factors because you have chronic back pain and you want a doctor you can establish a lasting relationship with. How old is the doctor? What is the doctor’s gender? What is their ethnicity? Can they speak your native language? Are they part of a big practice or a small practice? Does the doctor practice in multiple locations? Your insurance portal can’t tell you all of this information. ZocDoc can’t tell you all of this information. Ultimately, you are on your own to find out all of the important details about booking a specialist appointment.

Once all key considerations have been determined and decided, you are now tasked with making an appointment with the specialist, but is it the right doctor? Is it a good doctor? There is no where to find reviews! After all of these decisions, you must make the choice of specialist provider on a bit of faith (assuming you haven’t already given up). At this point, you are likely wondering again why your PCP didn’t just help you book the appointment!!

Here is the real secret about this whole process: your doctor wants to book the referral on your behalf, they just don’t have the tools to do so. Fortunately, that is changing as more and more doctors turn to referral management software. Referral management software help the PCP find the right specialist (takes patients insurance, has availability, is the right subspecialty, etc.) for their patients and enables the PCP to directly book the specialist appointment on behalf of their patients at the point of care. More and more PCPs are embracing referral management software. Hopefully, your PCP will sign up for a referral management service sooner rather than later!

Written by ReferWell

ReferWell is a New York-area digital health company that leverages the referable moment — the point in time when a person is most ready to take action to improve their health — to improve access to care, increase health plans’ quality performance and reduce the total cost of care while improving the members’ experience and outcomes. ReferWell’s intuitive technology platform and skilled service team helps health plans and providers manage value and help more people get on, and stay on, their healthcare journey by providing an optimized provider search, making it easy to schedule appointments at the point of care to increase patient compliance, and providing a service component to ensure providers close the loop regardless of the EMR they use.

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