Referral process!

[nana0909]

Hello! I am a new lvn currently starting work in a clinic. This is my first job as a nurse so the administrative process is still quite new and confusing to me. I have a couple of questions and clarification regarding referrals and the referral process within a clinic. (The nurses here do a lot of the referrals, so far it seems like how the process here is that the pcp would write the order for the referral then task for the nurse to complete the process. (Ex: patient needs stat referral to see a nephrologist, please refer patient out)

So my question is:

1) when a pcp refers a patient out to a specialist how do we know which provider/specialist exactly to refer the patient out to. (So for ex: if a pcp wants a patient to see, let's say a nephrologist how do we know which nephrologist the patient will see so we can properly fax over the papers to that clinic/specialist)

Or

Does it solely depend on the insurance and the clinic itself. As in the clinic usually have a designated specialist that they'll send patients out too? Or will we have to go searching for a nephrologist in that area to see if they take that patients insurance?

Thank you!

[Atl-Murse]

Have you tried asking your employer. this questions?

[nana0909]

I haven't no. The company I'm working for has multiple clinics, and it seems like each physician has their own way of processing the referrals but most of them have asked the nurses there to just process the it after they put in the order. And I've asked the nurses before but they seem to misunderstood my question

[roser13, ASN, RN]

Your employer/co-workers are the only ones who can explain their policies, procedures & preferences.

[mmc51264, BSN, MSN, RN]

they should have a list of preferred providers. We have a huge network of providers, so if the ortho attending wants a patient to see a urologist (acute urinary retention) our secretary just calls the urology clinic.

I'm sorry your nursing colleagues are not more helpful.

[nana0909]

Thank you!