Some health plans, like health maintenance organization (HMO) and point of service (POS) plans, still require referrals to see specialists. If your plan requires one, typically the physician or specialist who made the original diagnosis will make the referral.
“As a primary care physician, there is a certain network of specialists I like to use,” says Lee.
Typically, a PCP will initiate the referral process by selecting the appropriate specialist and coordinating with the office for an appointment to be scheduled. It’s a good idea to check with your health insurance plan to make sure the recommended doctor is a part of your health insurance provider network, to manage your costs.
Your primary care physician’s office is also a great resource to help you find physicians if you don’t need a referral for insurance reasons, since they’re familiar with your health history and can steer you in the right direction, says Lee. “A patient may think they need to see a neurosurgeon when they may need to see a nonsurgical expert,” she says.
In addition, your PCP can ensure that you’re seeing a trusted expert. “I don’t recommend getting second opinions from specialists who have not been vetted, since online reviews can be fabricated,” says Lee.
Virtual second opinions are another option. Those allow you to connect with doctors and specialists without leaving home. But the quality of care at virtual visits can vary.
“I am not a big fan of the virtual companies where there is no office, and you can’t see the physician,” says Lee. “I am a firm believer in being able to talk to a practitioner in person, but virtual visits and second opinions are appropriate for some health conditions.”
If your second opinion involves checking results from lab tests or X-rays or managing medicines, however, a virtual visit may be a convenient and potentially faster way to get an appointment.
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