Yes you can but only with the insurance companies permission!
This question arose from a group of consultants who referred patients to each other but always seemed to have problems in getting the invoice paid. Following a conversation with the insurance companies who had received the invoices the cause of the issue became very clear.
The consultants assumed that the pre-authorisation confirmed the patient could attend a clinic with any consultant. This is not the case.
Pre-authorisation is usually against a specific consultant.
If you follow the process the patient is normally referred to a specific consultant by their GP. Alternatively of course the patient may contact their insurance company and the insurance company refers them to a specific consultant. In either case a specific consultant is involved. If the consultant them refers that patient on to a colleague for whatsoever reason, it is unsafe to assume the pre-authorisation for the second consultant will stand. It may not.
What do you do?
In a perfect world the patient should have already contacted their insurance company and asked if the pre-authorisation can be transferred to the second consultant. Normally this is not a problem. But what do you do when the patient hasn’t contacted their insurance company and you are ready to invoice.
The only sensible thing to do is to speak to the insurance company concerned and explain why. In other words, the insurance company up to the point they are notified of the appearance of a second consultant, is blissfully unaware of his/her involvement with the patient. Consequently when they receive an invoice from a consultant not recorded against the patient they quite naturally be confused and could either delay payment of the invoice or worse, and very easily decline, the invoice. If this happens you will have no choice but to sort it out anyway.
Be pro-active
It makes much more sense therefore if you do need to refer a patient to a colleague or a patient has been referred to you by a colleague to make sure the patient’s insurance company is aware of what is happening. On the occasion(s) I’ve had to do this, it has resulted in either the issue of a new pre-authorisation against the second consultant or an amendment to the already existing pre-authorisation.
Insurance companies are NOT, as I’ve repeatedly said in numerous articles, the enemy. Nevertheless it is unreasonable to expect them just to pay out against an invoice from a consultant if they receive it from a completely different consultant to the one the expected.
You can transfer have a pre-authorisation transferred to a colleague but speak to the patient’s insurance company first please.
pete@medicalhealthcaremanagement.co.uk