When I need help with my taxes, I call my accountant (yeah I know I should do them myself).
When I want a GOOD cup of coffee, I drive down to my favorite local coffee shop (I still haven’t mastered my French press).
When water is leaking from the kitchen faucet, I call the plumber.
An expert. Someone with a specialized skill set who provides the BEST product or service.
So why when you have a UTI, ED or bladder leakage do you go to any doctor? Doesn’t your bladder or “junk” (yeah I meant male genitalia) deserve the BEST?
You deserve access to a urologist. A specialist in treating conditions of the female urinary tract and male genitourinary tract. When you think about it, the urinary tract and male genitalia are our “plumbing system.” When everything is moving through the pipes well, you’re happy in the bedroom and the bathroom.
So why haven’t you seen a urologist? Maybe you had no idea that there were doctors who specialized in plumbing. Or maybe you can’t seem to get an appointment with one.
One roadblock to specialist access in our country has been the referral process. I bet you’ve been the beneficiary of the following from a medical front desk staff member,
“We can’t see you without a referral from your primary care doctor.” (said in a nasally voice of course that is oh so lacking in warmth and compassion).
So what’s the deal with referrals? Can you see a urologist without a referral? The short answer is “YES!”. You can see a urologist without a referral but there are some stipulations.
Let us help guide you through your options. Because you don’t want to be caught with your pants down when your medical bill arrives.
It’s bad enough you’ll probably have to pull your pants down for the urologist.
What is the purpose of a referral to a urologist?
A referral most often refers to the transfer of medical care to a specialist. Primary care providers (PCPs) are the point guard of your healthcare team. Sometimes you, the patient, have an issue that requires passing the ball to a specialist.
There are two primary reasons for the medical referral process:
- To make certain you see the right doctor for the right problem.
- To save money.
I feel awful every time a patient books their own appointment to see me the urologist for “kidney problems” only to find out they actually needed a nephrologist (urologist vs. nephrologist).
Your primary care doctor may also have some inside knowledge about which specialist will provide you with compassionate, expert care. You’d hate to find out the hard way that you picked the specialist who’s a jerk.
I know it’s shocking to discover that insurance companies are trying to save money with the referral process. They seem interested in taking your monthly premiums while denying payment to physicians who provided you with care.
But there are some legitimate reasons for the referral system as a cost-saving measure. Specialty care is expensive. Requiring a referral from primary care, implements a “gatekeeper” for healthcare costs.
If everyone with “kidney pain” tried to book an office visit with the kidney surgeon that would be a problem. Not only would it cost the system millions of dollars, but the kidney surgeon would have less time to do what she is best at . . . kidney surgery.
Are referrals mandatory to see a urologist?
If you plan on using your medical insurance plan to see a urologist, then it’s always a good idea to first call your insurance company. Mandatory specialist referrals vary from state to state and plan to plan. Plus it changes by the day.
Health maintenance organizations (HMO) require you to select a primary care provider who then is responsible for making referrals to in-network specialists. This used to be mandatory across most HMO plans, but many have relaxed this requirement and allow for self-referral to a urologist.
But first . . . CALL YOUR INSURANCE PLAN TO MAKE CERTAIN YOU CAN SEE A UROLOGIST WITHOUT A REFERRAL. We hate surprise medical bills (more on this later).
If you have a PPO plan (preferred provider organization), then you typically do not need a referral to see a urologist. Just be certain that the urologist is one of the “preferred” in-network providers. Boy, this is confusing.
In the end you can go see whichever doctor you like. The issue is whether your insurance plan will cover the cost. Remember that sadly the whole process is about money.
One last point. Some antiquated urology offices will refuse to book you an appointment without a “referral.” Regardless of your insurance plan. This is total BS.
Unless the urology practice has an unusually high percentage of patients participating in HMO plans, requiring referrals for all patients is just a roadblock to getting access to their doctors.
If you haven’t provided the urology practice your insurance information, and they are requiring a referral before you can book an appointment, then run away. It’s a telltale sign they will treat you like a number instead of a person.
What is the best way to see a urologist without a referral?
Simple. Skip traditional insurance and pay cash. Now I know you may think this is not possible.
We’ve been brainwashed by the U.S. healthcare system which has led to a dependency on insurance companies. But yet, what do insurance companies provide?
- Increasing premiums
- Increasing co-pays and deductibles
- Unnecessary prior authorizations for care
- Failure to reimburse medical practices for care already delivered
- Long wait times on the phone only to speak with someone incompetent
Why do we accept this? Because we think there’s no other solutions. Not true!
Although it’s beyond the scope of this article, it’s worth considering alternative ways of funding your health care expenses. Health savings accounts (HSAs) and health matching accounts (HMAs) allow you to save up more efficiently for anticipated medical expenses.
But what if there’s an even better way? An affordable, cash visit with a board-certified urologist.
Enter VirtuCare. A telemedicine solution that connects you to the plumber directly so you can get the pipes flowing again.
VirtuCare – A Urologist Without a Referral
Urologists are in short supply. By the year 2025, it is estimated that there will be a shortage of 9000 urologists. The U.S. healthcare system seems uninterested in solving this problem because they are more interested in catering to big business.
That’s why we created VirtuCare. For $89 you can visit with a board-certified urologist from the comfort of your home. Access to expert care without a referral.
You’ll be connected with an expert who will listen to your concerns, prescribe any necessary medications or tests, and get you going on the path to recovery. If your issue requires a more hands-on evaluation, then we can help you find an appointment with an in-person urologist ASAP.
Now that’s service! A concierge experience for a fraction of the price. You can even use your HSA/HMA card to pay for the telemedicine visit.
If you’d like to keep your VirtuCare specialist for ongoing urological needs, then we offer an annual partnership for $99. Doesn’t that sound better than getting the “doctor du jour” with those big telemedicine companies?
Lastly you’ll actually see your doctor via a secure HIPAA compliant video visit. You don’t want to just text a doctor to get some pills. You want a compassionate physician whose smile alone says “everything is going to be OK!”
You might be saying to yourself, “you can’t actually provide good medical care with telemedicine?” Think again. Did you know that a physical exam is not necessary to treat many urological conditions?
Now if you have a lump that needs to be felt or have a history of bladder cancer requiring regular endoscopy, then telemedicine may not be right for you. But expert treatment of UTIs, sexual issues, and bladder problems can start with a thorough medical history through a home visit.
Stop fighting with insurance companies. Avoid hidden medical bills because you didn’t have a referral to see the urologist who spent 5 minutes with you.
Call in the “plumber” and receive expert urological care from the comfort of your home today.
Now if you’ll excuse me . . . I’m meeting my accountant for an espresso.