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22-05-2024

Referrals to specialised doctors: what do you need to know?

Iliustracija

The Health Insurance Fund would like to remind the population of the innovations in the issuance of referrals to specialists that have been introduced this year: the circle of doctors and other specialists who issue referrals has expanded, and there are more and more exceptions when a referral for a consultation is no longer needed.

Innovations will save time for both doctors and patients

In February this year, the referral  procedure was changed to reduce the administrative burden on family doctors and ensure continuity of care for patients. It provides that referrals for specialist consultations can also be made by a general nurse, an advanced practice nurse or a midwife in the cases specified in the legislation. 

In addition, referrals for specialist consultations, if necessary, can be made not only by a family doctor or a specialist, but also by an emergency room doctor or a nurse practitioner working with a doctor, at the doctor’s discretion. A referral for specialist advice from outpatient services may also be made by the doctor or nurse practitioner who has treated the patient in hospital at the doctor’s discretion, if it is determined that the consultation is necessary. 

A referral to a family doctor is also no longer necessary when a specialist determines that the patient needs long-term follow-up. He or she is immediately registered for long-term follow-up at the same facility, or is given a referral if another facility is chosen for such follow-up.

From 1 July, another patient-friendly innovation will come into force: urgent referral. The referral will include the reasons for the urgent referral and the justification for it, in line with the requirements set out in the legislation.

When is a referral not required? 

Free emergency medical care is provided to all Lithuanian citizens - both insured and uninsured - without a referral. A referral is also not required when a patient sees the same specialist for the same reason repeatedly on the doctor’s orders. Mental health services and a dentist working in the health facility where the patient is registered can also be accessed without a referral. A referral from a family doctor is not required for outpatient consultations with a dermatovenereologist at secondary level for all dermatovenereological diseases.   

This year, another innovation came into force: a referral for a secondary level consultation is not required when a patient tests positive for human immunodeficiency virus in a rapid screening or laboratory test.  This change applies when a patient seeks an outpatient secondary level consultation from an infectious diseases doctor, as well as a consultation from an infectious diseases doctor for internal medicine, paediatric infectious diseases and paediatric diseases in a university or republican level inpatient medical facility.

To avoid having to pay out-of-pocket 

Referrals are valid for 180 days, while a referral for a physical medicine and rehabilitation consultation is valid for 60 days. During the validity period of the referral, the patient must register or be registered with a health facility for healthcare services. The referring doctor must inform the patient of the facilities where the patient can receive the necessary consultation and remind him/her that it is up to the patient to choose the specialist and the treatment facility.

There is no need to pay for a specialist consultation if the patient has a referral from a doctor working in a healthcare institution that has an agreement with the territorial health insurance fund to pay for these services. 

(Freepik photo)

The NHIF invites you:

Last updated: 12-06-2024

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