Nova Scotians with private health insurance encouraged to check if they need referral notes

Nova Scotians are being encouraged to check their private health insurance to see if a note from a doctor or nurse practitioner is still required for massages, physiotherapists or chiropractors — because chances are, it’s likely not needed.

In a social media post last month, the Department of Health and Wellness said doctors have told them they receive “several requests a day for referrals to see physiotherapists, massage therapists and chiropractors.” The post said, “You likely don’t need one. Help free up doctors’ time by heading straight to the allied health professional.”

In response to a comment saying a referral is needed to get your private health insurance provider to pay, the department noted less than 10 per cent of plans in Nova Scotia actually require a referral.

“So for 90 per cent of the plans, the hope is to free up doctors’ time by avoiding needless visits for referrals,” the department said.

The department told CBC News in an email this week that its information came from the Canadian Life & Health Insurance Association. A spokesperson for the department said the trend of no longer requiring a doctor’s referral to be reimbursed “aligns with best practices for insurers.”

“We hope that fewer unnecessary appointments will mean doctors can spend more time with patients. If anyone is unsure, they should double-check with their insurance provider,” the department said.

Joan Weir, the vice-president of group benefits for the Canadian Life and Health Insurance Association — which represents all of Canada’s health insurers, told CBC News that data from its member companies show anywhere from three per cent to 18 per cent of insurers or employer groups still require referral notes.

“Our impression is there’s a real misunderstanding out there on behalf of patients and perhaps on behalf of prescribers and physicians that everybody needs a referral and that’s simply not true,” Weir said.

She said 30 years ago, most plans required a referral to ensure a treatment was medically required. But over time, she said many plans have realized it’s not necessary.

“There are other things an employer can do if they wish to manage their claims in this area a little bit more and so over time, it has been dropped by a lot of employers,” Weir said.

She said it is worth checking if the employer health insurance company to see if a note is required.

“Most people who have private benefits through an employer will have a portal that they can log into and access the information as to whether a referral is required. And if in doubt … go to your employer and ask because they will for sure know,” Weir said.

She said that, for anyone who is still required to provide a note from a doctor or nurse practitioner to access massages, physiotherapists or chiropractor, it would be up to their employer to make the change.

“I would suggest the employee go to their employer or go to their HR department and say, ‘This is causing extra time for me to go get a referral, it’s causing a bit of extra time on my physician or whoever is writing the referral. Is there any way we can eliminate this?’ And see what happens,” Weir said.