What is the Process of Referral Consultation in MSP Billing?
The referral consultation process is often interpreted in various ways, many of which are sometimes misunderstood and misused.
The referral consultation process is often interpreted in various ways, many of which are sometimes misunderstood and misused. The MSP billing system follows a well-defined procedure for consultation and referral.
What is the Definition of MSP Billing for the Process of Referral Consultation?
The Ministry in British Columbia states that consultation is when a healthcare or medical practitioner requests the opinion or services of another medical practitioner who is an expert in their field. A referral is made when a practitioner faces limitations in their medical expertise in a complex, ambiguous, or severe case. A healthcare practitioner includes any of the following professionals:
- Nurse practitioner
- Optometrist (for both ophthalmology and neurology consultations)
- Oral/dental surgeon for mastication cases
- Psychiatrists for substance abuse cases
Types of Consultation
One of the above practitioners can opt for a consultation with another doctor according to the patient's needs. There are three types of consultation in the MSP billing system as follows.
1- Limited Consultation requires all the parts of a full consultation but does not demand as much time and effort on the part of the medical practitioner as a full consultation does.
2- Full Consultation needs a complete service from the practitioner the patient is referred to.
3- Special consultation is done when a healthcare practitioner, such as an ophthalmologist, neurologist, or pediatric neurologist, refers their patient to another specialist for a special examination in a comparatively more complex case.
Referrals and Transferals
When one practitioner requests the expertise of another practitioner regarding a specific patient, that request is called a referral or transferal based on the responsibilities being shifted to the consulting practitioner.
The Referral Consultation Process
The MSP billing system’s process can be summarized into six steps:
1. The referring practitioner Informs the patient about the referral
2. The referring practitioner fills out a written request form with the details of the patient
3. The referring practitioner submits the request to the consulting practitioner
4. The consulting practitioner receives and acknowledges the request
5. The consulting practitioner prepares a medical report after examining the patient and sends it to the referring practitioner
6. The consulting practitioner continues the patient’s treatment
The referring practitioner carries out the first three of these steps, and the consulting physician completes the last three.
Transferal Consultation entails the temporary or permanent transfer of responsibility for the patient's care, from the transferring practitioner to another practitioner. It is needed when the transferring practitioner is unavailable to attend to the patient. Such conditions may arise when doctors go away on vacation, leave, or during other emergencies. In transferals, the responsibility of the transferring practitioner is completely shifted to the other practitioner. However, even if the responsibility for treatment is transferred to the consulting practitioner, the MSP physician billing process is handled by the transferring practitioner.
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