Referrals and Requests In Impulse and Medicare Referral Rules

Referrals and Requests In Impulse and Medicare Referral Rules

Referring Doctors

Access via:

  1. Admin\Referring Doctors or Ref Docs [Right hand Taskbar main Screen]
  1. Patient Details\Tab 4-Ref Doc
  1. Billing\Referral details\Add button or referral overrides click cancel.

Add Referring doctor in Impulse

Referring doctors need only be entered once

All locations the referring provider works at can be entered in the location section of the screen

Admin\Referring doctors

  1. Click ‘Search’ and check if the Provider is in Impulse.
  1. Click + to add referring doctor name. Done in the top half of the referring doctor’s screen.
  1. Enter referring Doctor name and complete details as you require
  1. Tick to save.

Add Referring doctor Location [Located immediately below the referring doctors’ name]

  1. More than one location can be entered for each referring doctor.
  1. Click + to add referring doctor Location or name.
  1. Select Medicare registration option.
  1. Enter referring Doctor location details
  1. Enter valid provider number for the location
  1. Tick to save

Add Patient Referral [Tab 4-Ref Docs]

  1. Select Patient details
  1. Select patient
  1. On bottom taskbar select  4-Ref Docs’
  1. Click ADD button [ right hand side of screen]
  1. Un-tick the option ‘Patients referring doctors only’ if referring doctor’s name is not in list.
  1. Type referring doctors surname
  1. Click ‘SELECT’ button
  1. Add Referral Details [On right hand side of screen]
  1. Select Location
  1. Select Provider
  1. Select issue date. Date on referral letter .Do not enter referral end date.
  1. Select Referral period.
  1.  Save.

Referral ‘First used date’ should only be entered if the referral was first used in another software program.

Requested Services can be entered at time of billing or as above. Where a consultation item and a requested item is billed it can be sent to Medicare in the same voucher with referral details.

Medicare Referral Rules
Referrals for specialist treatment

Patient referrals to a specialist or consultant physician for treatment, not including general practitioners, need to meet certain conditions.

The referral must include all of the following:
  1. relevant clinical information about the patient’s condition for investigation, opinion, treatment and management
  1. the date of the referral
  1. the signature of the referring practitioner.
  1. Referrals don’t need to be made out to a certain specialist or consultant physician.
  1. If you’re referring a patient, you should let them choose where to present the referral. This also applies to electronic referrals.

Single course of treatment

  1. A referral covers a single course of treatment for the referred condition.
  2. A single course of treatment is an initial attendance at the specialist or consultant physician.
  3. It includes subsequent attendances for the continuing management until the patient is referred back to the referring practitioner.
  1. A new referral doesn’t always mean a new course of treatment.
  1. If a referral is for continuing management of a condition, the specialist or consultant physician must bill subsequent attendance items.
However, you can bill an initial attendance item if it meets all the following:
  1. the referring practitioner decides the patient’s condition needs to be reviewed
  1. the patient is seen by the specialist or consultant physician after the expiry of the last referral
  1. the patient was last seen by the specialist or consultant physician more than 9 months earlier.
  1. If the patient has a new or unrelated condition, the specialist can start a new course of treatment if there is a new referral in place.

Referral periods from a GP to a specialist

  1. A referral from a general practitioner (GP) to a specialist lasts 12 months, unless noted otherwise.
  2. The referral starts from the date the specialist first meets the patient, not the date issued.
  1. If a patient needs continuing care, GPs can write a referral beyond 12 months or for an indefinite period.
  1. If a patient on an indefinite referral has a new or unrelated condition, the GP must issue a new referral for that condition.

Referral periods from a specialist to another specialist

  1. Referrals from specialists and other consultant physicians are valid for 3 months unless it's for an admitted patient.
  1. Referrals for admitted patients are valid for 3 months or the duration of admission, whichever is longer.

Lost, stolen or destroyed referrals

  1. A written referral that is lost, stolen or destroyed is valid for only one attendance by the patient.
  2. You must get a valid referral before you can bill any subsequent services.
  3. The account, receipt or assignment form must include all of the following:
  1. the referring medical provider’s name
  1. practice address or provider number of the referring medical provider (if known)
  1. the words ‘lost referral’.

 Requests for diagnostic imaging services

  1. Requests for diagnostic imaging services must have:

  1. the requesting practitioner’s full name, provider number or practice address

  1. the date of the request

  1. a description of the services requested.

  1. Patients can choose a health professional and don’t need to give a request to a specific practice. This also applies to electronic requests.

Requests for pathology services

Requests for pathology services must have all of the following:

  1. the patient’s name and address

  1. the patient’s hospital status

  1. the requesting practitioner’s full name, provider number and practice address

  1. a description of the services requested

  1. the date of the request.

  1. Patients can choose a health professional if there’s no clinical need for a specific pathologist to do the service. This also applies to electronic requests.


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