Info Desk [Paperwork, ordering, wait times, procedures, booklets, prescriptions...]

Once Medicare issues your referral, you just need to book an appointment—whether you do that in person, over the phone, or via email, depending on how the specific clinic handles things—and then you wait for your date. When you're making the booking, they’ll let you know which doctor is available.

Lisa Myers said:My primary care doctor is claiming she CANNOT prescribe a medication that a private specialist recommended. She’s insisting I absolutely need a referral from a specialist within the public healthcare system first. Meanwhile, my private doctor is telling me that’s total nonsense—he says he has the authority to write the script, it just depends on whether she actually wants to cooperate or not.

Does anyone have a clarification on this? Better yet, is there an actual article in the Law or some specific Regulation that explains how this works?

swiftbear86 said:I think the specific medication being used here is a massive factor. It really matters.
If you want to, just say the word.

I purposely didn't mention which drug class Alvent falls into. I didn't want to make it too obvious. We all know why that matters, right? Let's just leave it at that.

Maria Fisher46 said:Back when I was working in primary care, the staff at Medicare gave me a direct verbal instruction. They were very clear that the general practitioner... He doesn't owe anything. So, you want to get a prescription for a medication that a specialist recommended, but there's a catch: that doctor doesn't take Medicare.

When it comes to expensive medications, they gave me some very clear advice: don't even think about going down that road unless a specialist covered by Medicare signs off on it. To top it all off, they mentioned how often hospital specialists completely disregard whatever a private doctor recommends. And when that happens? Well, let's just say I'd rather not relive the fallout from those situations.

So, let's get one thing straight: is there actually a difference between "is not obligated" and "is not allowed"? Because to me, they aren't the same thing at all.

My monthly medication costs are hitting a certain level. $17 Before that, Serpentil had been prescribing it to me for months based on a private doctor's recommendation. $17If I remember correctly, she never actually said anything about this. Now, all of a sudden, I’m being told he isn't allowed to write the prescription. She originally gave me a month's worth, but now I'm stuck choosing between paying out of pocket or just heading down to the Mayo Clinic to have them write it there. If she does it herself, she'll run into legal trouble.

I sent an inquiry over to the Department of Health and Human Services. I haven't heard a single word back yet.

Take a look at pages 8 through 11—actually, just skim the whole brochure.

You might get a straight answer if you reach out to the Association directly.

Basically, if you haven't seen a specialist who actually takes Medicare, your doctor might just be following a specific rule of thumb.
It feels pretty backwards that she was fine prescribing Serpentil before but is suddenly drawing the line at Alvent.

I don't think she even needs a referral from a specialist, but I wouldn't be surprised if Medicare starts breathing down her neck about it.
Private doctors can basically say whatever they want since they don't have to deal with Medicare regulations—that’s usually why people head to private practice in the first place.

I’ve been through the hospital system myself, back before I switched to private care—they didn't prescribe this specific medication at all. My diagnosis was completely different then, too, and nothing they gave me actually worked. Honestly, I only started feeling better once I moved over to a private clinic.

I think I'll play dumb this month and just try ordering the meds over the phone, and we'll see what happens...

I recently visited the hematology department at the Mayo Clinic to follow up on some blood work from September. The hematologist noted on my results that I need to repeat a specific test—specifically for anticardiolipin antibodies—and then take those results to an immunologist.
I didn't actually catch that note on the report until later (in the meantime, I had already gone back there to have more blood drawn), and the doctor didn't mention anything about it during our appointment either.
Now I'm left wondering: who should I contact to arrange this re-test and get an Administration - Referral for the immunologist? Do I really need to head back to the hematology department just to get them to sort this out and schedule the blood draw?

Does anyone know how the blood draw process works at the Holy Spirit hospital?
My doctor handed me an Administration - Referral yesterday for some blood work and a 24-hour urine test.
She told me I need to get it done this Friday (tomorrow), but she didn't mention anything about making an appointment or any specific scheduling requirements.

Can I just show up there tomorrow morning without calling ahead?

Hey, I just received my referral for a thyroid ultrasound at Mercury.
I went through the central scheduling system to get it set up.

The thing is, they didn't actually tell me where I'm supposed to show up; I guess I'm wondering if I should head over to Vuk Vrhovac, which is where I usually go for my hormone panels, or if I’m actually expected to go to Zajčev for the ultrasound itself?

If anyone happens to know, please, I would really appreciate some help.
Thanks.

quietfox384 said:I went to the hematology department at the Internal Clinic for some blood work from September. The hematologist noted on my results that I need to repeat a specific test (anticardiolipin antibodies) and then take those results to an immunologist.
I didn't actually notice that note on the report until later (in the meantime, I already had to go back there to get more blood drawn), and the doctor didn't mention anything about it during our visit.
Now I'm wondering who I should contact for that specific test and how to get a referral to the immunologist? Do I have to head back to hematology to get them to handle it and draw the blood there?

I think your primary care doctor can write you that referral. I can't quite remember if mine was my GP or the immunologist who did it—part of my testing was ordered by my primary doctor, while for another part, the immunologist provided the referral.

If your primary care physician can't give you the referral, then either the hematologist or the immunologist can. If you end up going in for a follow-up, just ask that specialist to write it right then and there. You usually get the blood drawn wherever you normally go for labs; in my city, that’s at the main hospital lab. I did all my hematology and immunology blood work there in a single month. I'm not sure if hospitals everywhere organize things that way.

There’s also a high-quality private lab called Breyer located over on Broadway, near the Črnomerec area. In my experience, they really are the best—their results are just so reliable. They even offer home blood draws for patients who have a hard time getting out, which is such a helpful touch.

melloworca6 said:I think your primary care physician can write the referral—I can't quite recall if mine was my GP or my immunologist, since one set of tests was ordered by my general doctor while another part required a referral from the specialist.

If your primary care doctor isn't able to issue the referral, then either a hematologist or an immunologist should be able to—if you happen to have a follow-up appointment, just ask that specialist to write it right then and there. You usually pick up those orders at the same place where you get your labs done; in my city, that's the main hospital lab. I actually managed to get all my hematology and immunology testing done in a single month there—though I suppose I don't know if other hospitals are organized quite the same way.

Thanks for the reply!
I’ve already seen my gynecologist (she was the one who referred me to hematology, which is why everything feels even more confusing right now), and she suggested I reach out to my primary care doctor to handle the next steps, so I'll head there next.
Hopefully, the immunologist will be the one providing the necessary referrals moving forward—for all the specific tests and follow-ups he requests—but I suppose I first need to secure the initial referral to see him.
And yes, at this hospital, everything is handled in one centralized location; I'm just feeling a bit lost regarding which specialist needs to provide the referral for which specific test.😵

Lisa Myers said:I was in the hospital too, before I switched to private care—they didn't prescribe this specific medication, the diagnosis was completely different, and what they were giving me didn't help at all. I've felt so much better since I started seeing a private specialist.

I'm going to try playing dumb this month and just call in the prescription over the phone, we'll see how it goes...

Well, I actually did it—and I got the medicine. If I had gone to her, or if I had gone to the hospital and they hadn't prescribed the exact same thing the private doctor did, I would have wasted my money and my nerves, and I still would've had to buy the meds anyway. It's honestly best to play stupid sometimes, especially when you have a doctor who doesn't deserve your business.

Ended up in the ER this past Saturday because my eyes were acting up—total nightmare. Got an Administration - Referral to head over to the Internal Clinic tomorrow for a follow-up. Does anyone know what the wait times are looking like right now, or where I actually need to turn in the paperwork?
Got class tomorrow morning—just let me know when I should swing by so I can make sure I actually show up on time. 😁.

If the building doesn't literally crumble around you the moment you step inside, then you might actually make it to your appointment. It’s located right across from the Internal Clinic. Honestly, I wouldn't even dream of stepping foot in there. I heard about this one guy who nearly died there because of an infection following eye surgery; apparently, they were all away on vacation or something, so nobody was paying any attention to what was happening, back in August. He ended up having to be rushed to Rebro to save his life, and I think they managed to pull him through. You can still find that article online from way back in 2009. I mean, I assume the man isn't making things up if he went public with it. He even wrote a piece about the whole ordeal for The Washington Post.

My doctor referred me for a hepatobiliary ultrasound. They suspect there might be an issue with my liver, especially since I have high bilirubin levels—Gilbert's syndrome and all that kind of thing...

While searching online, I came across some special offers where a abdominal ultrasound goes for about $67, whereas it usually costs closer to $133. My question is: is an abdominal ultrasound the exact same thing as a hepatobiliary ultrasound, or are they different? 🙂

How long does an Administration - Referral actually stay valid for seeing a specialist? Thanks 🙂

I need to head over to the hospital in Springfield for a breast exam (over at surgery near the CT and EEG departments), and I’m trying to figure out the wait times. When the nurse tried to get me on the schedule, she mentioned they have walk-in availability, which supposedly means I could just show up whenever 🤔. I managed to snag a phone number so I'll give them a ring tomorrow, but I was wondering if anyone here has been there recently? If you have some firsthand experience with how long things actually take, let me know.

amberdriver5 said:My doctor referred me to get this done. Ultrasound of the hepatobiliary system.There's some suspicion regarding a potential liver issue. My bilirubin levels are elevated, and I have Gilbert's syndrome.

I was browsing online and stumbled upon some special offers, but for... Abdominal ultrasound. Keep an eye out. $67It’s all about what’s happening around here. $133Is an abdominal ultrasound the same thing as a hepatobiliary ultrasound, or am I missing something? 🙂

Is anyone actually here?

Maybe you should just check back with the clinic where you booked the appointment. We actually took my mom for a private abdominal ultrasound at Medikol earlier this spring. I can't quite recall the exact price, to be honest—I think I misplaced the receipt somewhere. But in my experience, Medikol is solid for screenings, and the doctor we saw was great too. I definitely wouldn't dream of going to Sun Insurance.

I’m not entirely certain if this is the right forum for this particular question... but I figured I would ask anyway.
It concerns providing a more affordable version of a KOBP medication to a patient. From what I understand, primary care physicians now have the authority to substitute an older, more expensive prescription with a cheaper alternative. However, if a patient insists on sticking with the original medication—which actually works effectively for them—and is willing to pay the small difference out of pocket, is the doctor "obligated" to provide that specific original drug?