administration

Referral

紹介状 (shōkaisho)

A referral is a formal recommendation or authorization from your primary care provider (PCP) to see a specialist or receive a specific service. HMO plans generally require a referral for specialist visits to be covered; PPO plans often do not. A referral typically contains patient information, the reason for the visit, and relevant clinical history. Without a required referral, the specialist visit may not be covered by insurance, leaving the patient responsible for the full cost.

Referrals serve as a gatekeeper function in HMO and some EPO plans, ensuring care coordination before specialist involvement.

In 9 languages

Language	Term
English	Referral
Japanese (日本語)	紹介状
Chinese (中文)	转诊
Korean (한국어)	의뢰서
Portuguese	Encaminhamento
Spanish	Derivación
Filipino	Referral
Thai	ใบส่งตัว
Vietnamese	Giấy giới thiệu
Romanization	shōkaisho

Related terms

• Prior Authorization 事前承認
• Primary Care Provider (PCP) かかりつけ医（プライマリケアプロバイダー）
• HMO (Health Maintenance Organization) HMO（健康維持機構）
• Specialist 専門医

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