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3 Ways Examinees End Up at Your Practice for Their Mammogram.

So, how do examinees end up at your breast imaging practice for their mammograms? For most, it boils down to three methods.

Direct Referral by Script

Getting an order from a physician is perhaps the most time-honored method for an individual to undergo a breast imaging procedure.

A patient with a traditional patient-physician relationship initiates this process. They make an appointment with their doctor for a wellness, routine, urgent, or follow-up visit. After evaluating the patient's current situation, the healthcare provider selects the most appropriate breast imaging procedure(s) based on the findings. They then generate a prescription with those orders.

The days of the ole prescription pad and pen are long gone to etch the prescriber's signature and their National Provider Identifier onto it. Instead, 84% are now e-prescriptions (Mikulic, 2023).

Self-Referred

If you are asking, does an examinee have to have a prescription from a doctor to have a mammogram? The answer is no! According to the FDA, women can have a mammogram and receive a follow-up report without a doctor's referral (Center for Devices and Radiological Health, 2023).

The follow-up to this first question is, must your practice accept self-referred examinees? Again, the answer is no! (In fact, state law makes it illegal in some places.) So, the prospective examinee must verify that a breast imaging practice can accept self-referring clientele before just showing up for a mammogram.

Remembering that special rules apply to the self-referred examinee is essential. They are to receive a copy of the written mammography report and a summary of the report written in lay terms. Since they present for their exam without a healthcare provider and acting on their own behalf, the breast imaging facility must provide these patients with the same information as the referring clinician.

Self-Requesting

The third way examinees can end up at your practice is a hybrid between having a prescription and coming in on one's own initiative.

Just like the self-referred examinee who declines to obtain a script for whom their provider fails to accept responsibility for their breast care, this class of individuals comes for a mammogram independently. However, self-requesting examinees differ.

These women can name a specific healthcare provider - or are willing to accept a healthcare provider offered by the practice - who takes responsibility for their clinical breast care. This provider agrees to receive the report of test results from the mammogram and assumes the obligations associated with the patient-physician relationship regarding their breast health moving forward (Iowa Health & Human Services, 2012).

Knowing Makes the Difference

Performing the actual breast imaging procedure may not be any different regardless of how the examinee presented to your practice. However, the patient type can directly impact who gets the report of test results, how follow-up breast care is managed, and even how the claim for reimbursement is processed.

That's why Mammologix suggests that its clients make sure there are clear policies & procedures in place that your entire team is knowledgeable about for situations like these.

References

Mikulic, M. (2023, May 30). E-prescription rate U.S. 2021. Statista.

https://www.statista.com/statistics/864380/share-of-us-e-prescriptions

Center for Devices and Radiological Health. (2023, June 16). Frequently asked questions about MQSA: FDA. U.S. Food and Drug Administration.

https://www.fda.gov/radiation-emitting-products/consumer-information-mqsa/frequently-asked-questions-about-mqsa

Iowa Health & Human Services. (2012, Oct). Guidance for Facilities Choosing to Accept Self-Referred Patients.

https://hhs.iowa.gov/media/11550/download?inline=