Eligibility Verification Services for
Healthcare Providers

Eligibility Verification Delays Are Costing You Revenue. OneMed Billing’s expert
Credentialing Services streamline provider enrollment, prevent claim denials, and
accelerate approvals—ensuring you get paid on time without administrative
hassles.

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30%+ Increase in Collections

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90% Recovery of Outstanding Claims

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50% Reduction in AR Days

What Are Referrals In Medical Billing and Why Are They Needed?

Many times, your primary care doctor must have asked you to see a specialist, to get expert advice and care to manage your clinical condition. Seeking assistance from another specialist for additional services and management is considered as a “Referral” in Medical Billing.

The fundamental thing about ‘Referral’ is that you need to take consent from your primary health care doctor before you take an appointment from another specialist. If not, your health insurance plan will not be responsible to bear the cost of the appointment consequently.

In order to make sure that you get paid for the treatment, a ‘Referral’ from your doctor is a must. Under medical billing, it is a significant record obtained from a provider so that you can acquire the specialized services from a specialist, your doctor has referred you to. ‍

What are the essentials for the referrals that one needs to keep in mind?

Referrals should be in a written format and not verbally told to you for further acceptance by another doctor.

It must mention the date of approval such that a patient can use it within the time period of 18 months.

Adequate particulars about the patient’s health condition should be provided in the referral.

It must be officially signed by the practitioner who has given you a referral to show it to the specialist.

The Primary care doctor must specify the treatment in the referral for the specialist to consider it.

In circumstances of emergency, referrals in a written format is not required.

How Our Referral Management Works

For patients:

  • Immediate diagnosis and management

  • Saves time and the treatment becomes cost effective

  • Better health outcomes

For the family doctor:

  • The doctor gets to learn how to deal with the disease

  • Communication between the healthcare staff and the specialists at a different organization increases

For the consultant:

  • IImprove the quality of the patient’s management

  • Have additional time to spend with the patient

  • His feedback to the family doctor can help the patient use his healthcare plan effectively

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