Is there a limit on referrals for children?

Is there a limit on referrals for children?
Is there a limit on referrals for children?

Are there any restrictions on the issuing of referrals to various specialists, as well as on the examination of a blood count for a 4-year-old child by the general practitioner? According to our personal doctor, only pediatricians have them without restrictions. And one more question: are children exempt from a user fee when conducting research in a laboratory? It is about a child who gets sick often

Mikhaela Georgieva, city of Plovdiv

The general practitioner can issue a referral for a consultation with a specialist (form MH-NHOC No. 3) or a referral for medical-diagnostic activities (bl. MH-NHOC No. 4), in the case of a blood count - if necessary and judgment, after an examination, depending on the patient's state of he alth.

The general practitioner issues outside of his specified activities, i.e.f. beyond the limit, referral for consultation of people up to the age of 18 by a doctor with acquired speci alty in "Pediatrics", "Children's gastroenterology"; "Pediatric endocrinology and metabolic diseases"; "Pediatric Cardiology"; "Pediatric Clinical Hematology and Oncology"; "Pediatric Neurology"; "Pediatric Nephrology and Hemodialysis"; "Pediatric Pneumology and Phthisiatry"; "Child Psychiatry"; "Pediatric rheumatology" and "Pediatric surgery" - once for each acute illness.

There are no restrictions on the number of medical referrals issued by the general practitioner during the year for acute conditions. However, the doctor is the one who assesses the necessity of issuing a referral for examinations and tests - whether the condition is urgent or suffers some delay.

You can file a report with the Regional He alth Insurance Fund (RZOK), with which the child's GP has a contract, describing all the circumstances of the case related to the impossibility of being served by the GP.

On the issue of whether it should be paid in the laboratories, since it is a child, we inform you that only people without income, housed in homes for children and adolescents, in homes for preschool and social care children.

Children are exempt from the user fee at the doctor, but not at the laboratory. When the he alth insured go to a laboratory, which has concluded a contract with the NHIF, with a referral for medical-diagnostic activity (Bldg. MH-NHIF No. 4), they must pay the so-called price "biological material".

For medical-diagnostic activities in the laboratory, the relevant contractor can set a "biological material" price, the amount being paid by he alth insurance. In the event that the patient pays a "biological material" price, the medical facility cannot demand from him for tests in the same laboratory a fee under Article 37, paragraph 1 of the He alth Insurance Act, the so-called user fee.

In medical facilities performing medical-diagnostic activities, for which no "biological material" price is paid, the he alth insured pay the fee under Article 37 of the Law on He alth Insurance (i.e., user fee).

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