Charging to Arrange a Referral

RE: Charging to Arrange a Referral

Anthony Todd — Sat, 03 Oct 2015 16:06:34 GMT

[quote user="Martin Atkinson"]

[quote user="Gillian Mostyn"]Wow. Your comments never fail to surprise me....and reminds me of the old joke regarding the difference between a vet and God![/quote] I don't see why, we're all perfectionists to a greater or lesser extent, I do feel an element of failure when I can't achieve the high standards I set myself and there's the hangover from having to be omni-competent when there was little alternative. Less so now maybe because there are occasions when I need something done that requires specialist equipment I cannot afford.

[quote user="roland bulkyn-rackowe"]I'm not sure whether insurance companies would cough up for this fee [/quote] They would have no choice it is a professional service, different than charging to complete a claim form but then that can still be hidden![/quote]

Me too, I always felt slightly uncomfortable referring something as, back in the day, vets were supposed to know everything about anything that was an animal.

I remember a very eminent member being mortified when he referred a rare eye condition to a specialist and the client said "Why, don't you know, you are a vet?"

Times and attitudes change and, now there is the added pressure in that, if you plaster a fracture and it goes wrong, but you are not a recognised specialist you'll have a hard job defending a claim.....

Conversely, and unfairly IMHO, if a recognised specialist has one that goes wrong it's fine [remember the crushed puppy's foot that super-vet should never have touched]

Unless things change soon, all the new vets [and even the "modvets] will just be referral deciders and not touch an animal at all....

RE: Charging to Arrange a Referral

Gillian Mostyn — Sat, 03 Oct 2015 14:18:43 GMT

[quote user="Silvia Maldonado"]I don't know that joke! Is there really any difference between a vet and God? [/quote]

Yes. God doesn't think he's a vet.

RE: Charging to Arrange a Referral

Silvia Maldonado — Sat, 03 Oct 2015 14:16:56 GMT

[quote user="Gillian Mostyn"]

Wow. Your comments never fail to surprise me....and reminds me of the old joke regarding the difference between a vet and God!

[/quote]

I don't know that joke! Is there really any difference between a vet and God?

RE: Charging to Arrange a Referral

Peter Ding — Fri, 02 Oct 2015 16:29:43 GMT

Why not charge appropriately? Pro rata.

Less if it's routine by email delegated to a nurse with minimal interraction (although they should contribute towards your clever computer system that attaches all nec. info to an email.)

More if its urgent and takes a considerable amount of veterinary time, tel. calls. follow up etc

Free if its referral to the RSPCA for a non-registered impecunious client with a pyo. who should have gone there in the first place.

Discounted if you feel you could/should have done better but you know you are just being hard on yourself.

RE: Charging to Arrange a Referral

Martin Atkinson — Fri, 02 Oct 2015 15:14:42 GMT

RE: Charging to Arrange a Referral

Silvia Maldonado — Fri, 02 Oct 2015 01:18:35 GMT

No charge either, although we charge £40 ambulance service for a transfer to a member practice, if needed, and not OOH, obviously.

RE: Charging to Arrange a Referral

Michael Woodhouse — Thu, 01 Oct 2015 23:23:15 GMT

[quote user="Mike Martin"]But in the other extreme, if making a referral is asking your receptionist to call my practice to register a client and then email the clinical notes direct from your PMS and that is less than 1/2 a page and just says 'heard a murmur' refer to MM, that is really no time at all. In those cases I think it is unfair on your client to charge.[/quote]

(You may all tell me I am out of touch) but I've always spoken to someone at a referral centre before sending an animal. Sometimes its just been a nurse, but it's has always taken up my time. Anything slightly unusual and I want to speak vet to vet. Everything gets a letter written by me (even if handwritten on headed paper and sent with the horse with colic).

We have a fixed fee for reporting lab results, and sometimes that is a 10 second voicemail message "fluffy's bloods have come back normal, ring if you want to discuss" and sometimes it can take a heap of research and you've invested 45 minutes in the case for £7.50...... My point, having gone around the houses, is that it is an average. The owners don't see how much effort goes into chasing and reporting bloods, or arranging a referral, but that doesn't mean we shouldn't charge.

It's on the agenda at the next practice meeting as of NOW!

RE: Charging to Arrange a Referral

Mike Martin — Thu, 01 Oct 2015 23:00:35 GMT

Interesting discussion and a good one to air.

From my end, I'd estimate 10-15% of practices itemise a charge on their clinical notes. I often ask owners how much that was and generally is it £15-25, but the range is bigger.

I think it is always perfectly reasonable to charge your time.

But in the other extreme, if making a referral is asking your receptionist to call my practice to register a client and then email the clinical notes direct from your PMS and that is less than 1/2 a page and just says 'heard a murmur' refer to MM, that is really no time at all. In those cases I think it is unfair on your client to charge. but practices that have a fixed policy of always charging, will still do so.

You then also need to consider the PR aspect of how your clients perceives the value in charging for that referral, esp if 'they' think it took no time and there were not a load of notes or results to gather and email. Or, the frustration and irritation of your client when they find out we had not received the x-rays (or whatever) - and so you charged for something that was not properly done (and we all forget, get busy or things slip - much less of an issue if there had not been a charge).

It 'should' be that your financial reward comes in the resupply of 'lifelong' medications, recheck exams and follow-up bloods, etc and of course a happy and bonded client - because you knew of a good place to send them, where things got properly sorted. But I also appreciate that other referral centres do not always operate that way.

So I do not think there is a hard and fast rule in this one.

RE: Charging to Arrange a Referral

nikki — Thu, 01 Oct 2015 20:39:59 GMT

We charge. I think it's the same as a consult fee. It certainly can take ten mins to organise everything. Most clients seem to understand it once it's been explained. Insurance companies seem to pay up.

RE: Charging to Arrange a Referral

James Ede — Thu, 01 Oct 2015 16:38:32 GMT

Hi Mike- long time no see. I have always worked in practices that do. And when I had my own, we charged a standard £20 plus vat. Another query was whether insurers would pay it. As far as I recall, they always did. It's a fee for my time, in much the same way as a consult fee. We were transparent, and it was listed as a 'referral fee', so no hiding it as a consult etc.

RE: Charging to Arrange a Referral

Rob Loxley — Thu, 01 Oct 2015 15:35:47 GMT

We charge the same as a reduced consult

RE: Charging to Arrange a Referral

Anthony Dennison — Thu, 01 Oct 2015 11:12:53 GMT

We charge £23, slightly less than a consult fee.

RE: Charging to Arrange a Referral

Michael Woodhouse — Wed, 30 Sep 2015 23:28:48 GMT

Anyone who charges prepared to say how much? (Anon account?)

Thinking it through, I'd have thought we'd be looking at £25-50+ if looking to charge the time properly (phone calls, referral letters etc).

RE: Charging to Arrange a Referral

Rob Loxley — Wed, 30 Sep 2015 19:20:44 GMT

We do, can take fair bit of time, effort, phonecalls, letter, so feel justified in charging for our time

And I can't remember any insurance companies who have excluded this from the claim

RE: Charging to Arrange a Referral

Roland Bulkyn-Rackowe — Wed, 30 Sep 2015 15:59:28 GMT

I can't find anything in the guide to say that there is a formal RCVS position. Clients should be aware of the cost and that's as far as I could read into this. I'm not sure whether insurance companies would cough up for this fee (as it's as much admin as anything). Does anyone have any experience of this? I have been asked by the manager to charge so I'll toe the party line, and can see from comments that most think charging is a reasonable thing to do. We're not working for free and the referral I arranged on Monday (emergency neuro) did take up an extraordinary length of time.

RE: Charging to Arrange a Referral

Gillian Mostyn — Wed, 30 Sep 2015 15:39:54 GMT

We don't charge, but maybe we should......

I don't feel guilt about referring....quite the opposite. I feel more guilt when I have to muddle through when referral isn't an option, but I know someone else could do a better job!

RE: Charging to Arrange a Referral

Evelyn Barbour-Hill — Wed, 30 Sep 2015 15:33:47 GMT

[quote user="Martin Atkinson"]Depends on the client, how much I've already taken from them and how much guilt I feel for not being able to deal with it myself.[/quote]

More or less the same with me.

RE: Charging to Arrange a Referral

Gillian Mostyn — Wed, 30 Sep 2015 15:29:15 GMT

[quote user="Martin Atkinson"]how much guilt I feel for not being able to deal with it myself.[/quote]

Wow. Your comments never fail to surprise me....and reminds me of the old joke regarding the difference between a vet and God!

RE: Charging to Arrange a Referral

Tim Browning — Wed, 30 Sep 2015 11:52:06 GMT

Does the RCVS have a position on this?

RE: Charging to Arrange a Referral

Hannah Wynne Richards — Wed, 30 Sep 2015 10:50:44 GMT

It's a professional service, so it's fully ethical to charge. I don't, but that's just a gesture of goodwill on my part.

Wynne

RE: Charging to Arrange a Referral

Martin Atkinson — Wed, 30 Sep 2015 10:49:28 GMT

Depends on the client, how much I've already taken from them and how much guilt I feel for not being able to deal with it myself. Same with charging to complete insurance forms. Someone who is a bit arrogant and/or wanted a referral before they'd even given me the chance to investigate/treat it myself would probably be charged the equivalent of a consultation fee. Doesn't happen very often though - in fact I can only think of one occasion.

RE: Charging to Arrange a Referral

Lucy Fleming — Wed, 30 Sep 2015 10:43:39 GMT

We do. Like Michael said, they can sometimes eat up a lot of time. (Others are just a matter of a quick phone call or email but collating history and lab results etc still takes time.

RE: Charging to Arrange a Referral

Michael Woodhouse — Wed, 30 Sep 2015 09:50:19 GMT

We don't, but I sometimes think we should. Can eat a lot of time, making phone calls, chasing people up. Researching who is better for a particular thing etc.

RE: Charging to Arrange a Referral

Bob Russell — Wed, 30 Sep 2015 09:14:05 GMT

We don't but you are entitled to charge for anything that costs money. Any professional obligation is (IMO) limited to making the decision to refer or not!