Can I take my referral to any specialist?
You've got a referral, but can you pick your own specialist?
If you’ve ever visited a specialist, it’s likely you used a referral from your GP to get the appointment.
But what is a referral? Are there different types of referrals? And, how long does a referral last?
Although the concept is simple, there are a whole lot of questions that you’ll probably have about referrals. To help answer those questions, we spoke with nib Group Medical Advisor and GP, Dr Hamish Black.
The government’s healthdirect site explains that a referral is simply a written request from one health professional to another asking them to help diagnose or treat a patient.
The referral process is beneficial because it allows your GP to continue managing and overseeing your broader health needs, while passing on specific conditions or concerns to a specialist in that area.
Although your GP may have a preferred specialist that they list on your referral, it’s important to know that you’re not bound to visit that specialist – in fact, you can opt to take your referral to a specialist you are more comfortable with, regardless of who your GP has suggested.
Generally, a referral from your GP will last around 12 months
Generally, a referral from your GP will last around 12 months, but there may be exceptions depending on your personal health situation.
In some cases, referrals can be as short as three months if the GP feels it’s best to have more consistent and close points to check in on the patient’s health and progress.
“Shorter referrals can be given out if the patient is requiring multiple specialists for physical and mental care,” says Hamish. “There are often social, mental and physiological areas to be addressed in shared care, and being able to check in with your GP, who is overseeing the scope of care, can be very helpful for the patient.”
Three month referrals are also required when a referral is from one specialist to another.
The short answer is yes. Your referral can be transferred to the specialist of your choice as long as the new specialist is in the same specialty field. Check out our dedicated article to find out how to transfer your referral.
An indefinite referral is a referral that doesn’t have an end date. These types of referrals are generally reserved for patients who have illnesses or health requirements that need the ongoing management and care of a specialist.
“The main specialist areas that require indefinite referrals are for cardiologists, respiratory physicians and nephrologists where conditions are often lifelong in nature,” explains Hamish.
“Indefinite referrals can also be for other chronic illnesses like diabetes.”
It’s illegal for a GP or specialist to backdate a referral in Australia. However, if you’ve lost or accidentally destroyed a referral, you are able to continue your specialist appointment. If this happens, you’ll be able to get a new referral from your GP after your appointment that will indicate ‘lost’ on it.
“Medicare will still accept this,” explains Hamish. “However, only one of these is allowed per specialist, so it’s not a process that is recommended. It is purely in the instances of genuine loss of referral.”
Once you do receive a referral from your GP, it’s important to find a specialist that you feel comfortable with. You’ll have to consider things like location, cost and availability, as well as their reputation. Not sure where to start? Check out our article: Finding a great specialist: it’s all about knowing what to ask.
If you're an nib member heading to hospital soon, make sure you check out our Going to Hospital page. This tool gives you information on health insurance, tips on how to reduce any out-of-pocket expenses and helpful questions to ask your specialist. To find out the details of your current policy, chat to someone about your upcoming hospital visit or get some guidance, call us on 13 16 42.
Dr Hamish Black is the nib Group Medical Advisor. He has been a Medical Practitioner for over 25 years, trained as a General Practitioner and continues to practise as such two days a week. Hamish has also spent many years working in Emergency and Medical Assistance, including leading the nib travel clinical team. He has worked in rural and urban environments in Australia and the UK, including time with the Royal Flying Doctor Service.