Named Outpatient Referrals in South Australia

The good GP has a stewardship role in the Australian medical system and part of this is referring to subspecialist and hospital care. This is an important role and we don’t take it lightly. We want to do our best for our patients and help them get the care they deserve. One of the challenges is referring to public hospitals, where our referrals sometimes get ‘bounced’ back to us. In private practice, for the patient to receive a (Federal) Medicare Benefit (like when you see Your GP), the GP referral must be to a named provider (Dr Smith, Dr Jones, for example). When referring to a public hospital, there has historically been no Medicare rebate for the patient – public hospitals are funded by the State Governments and Medicare is funded by the Federal Government, and care is free at the point of service. This is changed recently, and public hospitals are now using Medicare funds to run their services. Therefore they now seek named referrals. But to who? It’s very hard to find out exactly which doctor will be seeing you, and so it’s hard to do a named referral, which may delay you being seen.

So, as a public service, we’re Here to Help! Bernie Cummins (Director of Nursing Statewide Outpatient Reform) has provided the following documents to help GPs and patients navigate this system and avoid the ‘named referral bounce’.

directive+medicare+billing+outpatients

medicare+directive+and+outpatient+private+practice

Good luck, and may the odds be ever in your favour!

Feel free to email the Southern Regional GP Council for issues with named referrals – we will be happy to relay you concerns to the people and areas where the decisions are made

enquiries@srgpc.com.au