Q&A with Dr. Tom
What do I do about a patient that requests specialty referrals but won't come in for a routine exam?
Call the patient yourself and tell them you've received the referral requests but that as part of the insurance coverage they chose, they need to see you first for an evaluation.
Many patients sign up for Medicare Advantage without being completely educated on how it works. Give them that education. Refer them to my post on how Medicare Advantage works.
And ask them to come in.
Tout the health benefits and cost savings inherent in such an encounter.
If this is the first time this has been a referral problem with this patient, consider signing a referral sight unseen — if the patient agrees to make an appointment.
But if after your explanations and efforts, she still doesn't follow through or repeats the behavior, don't issue any referrals at all.
What you have there is more than likely a "gamer."
Someone who wants the benefits of their Medicare Advantage plan with none of the restrictions, none of the costs.
In essence, she's asking you to pay for at least part of the cost of her medical care.
Don't let the patients on your panel do this to you.
You're much better off without them.
Your insurance company and employers know the score. Any complaints will fall on deaf ears, so don't worry.
Once they realize you won't play along, these patients will try to find some other sucker to support their uneducated (or dishonest) approach to healthcare.
These patients tend not to have a very great circle of influence---and the folks they do have influence over, you don't want. So any bad word of mouth is not a real concern.
Don't be a patsy for these patients trying to get extra benefits for no extra cost.
If one of your patients tries to turn you into a "referral monkey"--- just say no.