E-referrals in Ukraine—Who Issues Them and When Are They Not Required?
Electronic referrals have long been a common part of the Ukrainian healthcare system. According to the Ministry of Health, doctors issue approximately 200 million e-referrals each year for consultations, lab tests, and medical examinations. The ministry explained who is authorized to issue them, how to access the service, and in which cases a referral is not required at all.
An electronic referral is an entry in the electronic healthcare system that enables a patient to receive a prescribed medical service. According to the Ministry of Health, Ukrainian doctors create about 200 million e-referrals each year. They are used for consultations with specialists, laboratory tests, and various diagnostic procedures.
Who issues e-referrals
An e-referral is created by the doctor who, after an examination, determines that the patient needs a specific medical service. This can be either a primary care physician or a specialist. Doctors working in private medical facilities can also create e-referrals.
In other words, the patient does not always need to see a family doctor first. What matters is which doctor determined the need for a consultation, test, or examination. Once the referral is created, the information is entered into the electronic health care system.
What the Patient Receives
After an e-referral is issued, the patient receives a notification on their phone. It includes the referral number, which will be needed when visiting the healthcare facility. If a person does not have a phone, this does not mean they cannot use the referral. In that case, the doctor can provide a copy of the record in paper or electronic form.
To receive the service, you must go to the healthcare facility that provides it and provide the e-referral number. You can also show the barcode on the information sheet, if available. The facility will verify the referral and confirm whether the requested service is available, after which the patient will be scheduled for an appointment or examination.
Do you have to pay for the service?
Having an e-referral does not automatically mean that any service will be free of charge. The service must be provided free of charge if the selected healthcare facility has a contract with the National Health Service of Ukraine (NSZU) for the corresponding package under the Medical Guarantees Program. You can find the right facility using the NSZU’s electronic map. There, you can check exactly where the service you need is provided.
Another option is to call the NSZU contact center at 16-77. A patient can choose a healthcare facility that has the necessary contract with the National Health Service of Ukraine (NSZU), regardless of where they live. Before your visit, the NSZU advises you to clarify the appointment conditions and the availability of the service in advance.
When an e-referral Is Not Required at All
There are several cases in which a patient can see a doctor without a referral. Specifically, you can see the following specialists without an e-referral:
- an obstetrician-gynecologist;
- a psychiatrist;
- a dentist;
- a substance abuse specialist;
- a tuberculosis specialist.
A referral is also not required if a person needs emergency medical care. In other words, in an emergency, you don’t need to first find a family doctor or fill out an electronic form.
What to Do If You’re Referred to Another Specialist
Sometimes a patient comes in for an appointment with a specialist, and during the consultation, the doctor realizes that another specialist or additional tests are needed. For example, a neurologist may determine that a consultation with a cardiologist is necessary, or a doctor may order additional tests. In such a situation, the new e-referral must be created by the very doctor who determined the need for further testing or consultation. The patient should not simply be sent back to their family doctor for a new referral.
The Ministry of Health specifically emphasizes that referrals for tests or examinations must be issued by the doctor who ordered them. This applies particularly to specialized tests. For example, an e-referral for a CT scan, MRI, or specific laboratory tests can be issued by a specialist. A primary care physician does not have this authority.
What to Do If a Doctor Refuses
If a specialist has ordered an examination but refuses to issue an e-referral for it, the patient may contact the head of the medical facility. If the issue cannot be resolved on the spot, the Ministry of Health advises contacting the National Health Service of Ukraine (NSZU) call center at 16-77.
The National Health Service of Ukraine (NSZU) also accepts complaints regarding cases where a medical facility unreasonably denies free services or demands payment for care that is supposed to be provided under the Medical Guarantees Program.
Key Information for Patients
An e-referral does not necessarily have to be issued by a primary care physician. It must be issued by the healthcare professional who determined the need for a specific consultation, test, or examination. The patient receives the referral number on their phone and can then contact the healthcare facility that provides the necessary service. If that facility has a valid contract with the National Health Service of Ukraine (NSZU), the service will be free of charge to the patient under the Medical Guarantees Program.
However, in an emergency or when consulting certain specialists, an e-referral is not required at all. This information comes from a press release by the press service of the Ministry of Health (MOH) of Ukraine.
