Reservations over the introduction of open referrals in the private healthcare market can be allayed through greater medical expertise in the health insurance claims process a Healix Health Services has said.
The Federation of Independent Practitioner Organisations recently raised its concerns about the introduction of open referrals, identifying the concerns of GPs about lack of choice for patients.
However, Sophina Gapare-Mburia, commercial manager at Healix, said: "It is understandable that GPs have concerns about how they can ensure their patients receive the best possible treatment and, at the heart of these concerns is probably the decision-making process."
"We believe the best way to give GPs confidence in the health insurer's decision is by making Registered Nurse Case Managers integral to the claims process."
She added that nurses' detailed knowledge and understanding of healthcare delivery means they can provide guidance on the choice of healthcare providers, based on clinical need and availability of services.
"As a result we can provide valuable support to employees and guide them through the process of seeking treatment, whether NHS or private," she said.
"It is not surprising that GPs have concerns about any perceived loss in choice for their patients but at Healix Health Services we strongly believe that these concerns can be addressed in a collaborative way which will still achieve cost control for employers."
