Risk Management



Referral Form for Managed Care Patients

REFERRAL FORM FOR MANAGED CARE PATIENTS

 

Date:                                                  

 

Dr.                                                        has referred you to Dr.                                              

 

Phone:                                                

 

This referral is:

                                          Emergency

 

                                           Urgent (24-48 hours)

 

                                           Timely (1-2 weeks)

 

                                           When convenient

 

This appointment will have to be made for you by your primary care physician,

Dr.                                                       , who has been notified.  If there are any problems scheduling this appointment, please contact this office.

 

For office use only:

 

Outcome:                                                                                                                                           

 

 

(Original to patient. Copy to chart.)

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Six reasons OMIC is the best choice for ophthalmologists in America.

#3. Best at defending claims.

An ophthalmologist pays nearly half a million dollars in premiums over the course of a career. Premium paid is directly related to your carrier’s claims experience. OMIC has a higher win rate taking tough cases to trial, full consent to settle (no hammer) clause, and access to the best experts. OMIC pays 25% less per claim than other carriers. As a result, OMIC’s base rates have consistently averaged approximately 15% lower than multispecialty carriers in the U.S.

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