Is the secondary examination with a specialist without a referral still paid?

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Is the secondary examination with a specialist without a referral still paid?
Is the secondary examination with a specialist without a referral still paid?
Anonim

I had to go to a specialist, without a referral from the GP. I paid for the review. I am wondering if the secondary examination in my case also has to be paid or since I am without a referral, the amount due is a one-time amount?

Anelia Shtereva, Pazardzhik

The secondary examination is based on a referral issued (Bldg. MOH-NHOC 3) and a primary examination performed. Once the primary is "cash", the secondaries will be as well. But the next examination can be carried out with a referral from the NHIF and then it will be paid to the SIMP contractor as primary.

According to the regulations (Art. 155 of the 2020-2022 NRD): Specialist doctors who provided medical assistance to persons with continuous he alth insurance rights, without a referral from the personal physician, have the right to issue referrals for providing specialized medical assistance from other specialists (bl. MOH-NHOC No. 3), for highly specialized medical activities (MOH-NHOC No. 3A), for medical-diagnostic activities (MOH-NHOC No. 4).

The referrals issued by these specialist doctors, who have signed a contract with the NHIF, are within the scope of their specified number of specialized medical activities and the value of the appointed MDDs, but not more than 10 percent of their total number.

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