What is the definition of self-referral?

The definition of self-referral is accurately represented by the choice that describes a patient who refers themselves to a specialist. This situation occurs when a patient decides to seek specialized medical care without a direct recommendation or referral from their primary care physician. Self-referral can happen in various medical scenarios where patients might feel they need to see a specialist for specific health concerns and choose to pursue that route independently.

This practice has important implications for both patient care and healthcare costs, as it often bypasses the more structured referral process typical in many healthcare systems. Understanding the dynamics of self-referral is essential in the context of medical billing and coding, as it can affect coding decisions, insurance claims, and patient outcomes. It is also necessary to note that self-referral may lead to issues such as unnecessary tests or treatments if the decision isn't guided by medical professionals.