Section 3: Responsibilities Before Referral

Top 3 Takeaways

1. The PCT and SCT share responsibility for a successful referral process, including decisions on preferred communication methods and streamlining processes for record sharing.
2. The SCT/PCT should make a specific referral roadmap available and accessible to all parties, including clients.
3. The PCT should always discuss the reasons for referral, cost estimates (if known), and the referral process with the client.

Information to Be Shared Between the PCT and SCT

1. Reason for referral
2. Timing and urgency of referral
3. Scope of referral (e.g., referral to a board-certified veterinary dentist to treat a fractured tooth that may need to address other diseased teeth)
4. Preferred communication frequency and methods
5. Instructions for referral (provided by SCT)
6. Medical records, diagnostic imaging, and other pertinent details (provided by PCT)
7. Diagnostic and/or preoperative testing to be done before the referral (e.g., expected/preferred diagnostics before the client’s referral appointment can be listed on the SCT’s website and/or referral portal)
8. Consider cost-effective strategies (i.e., avoid repeat testing whenever possible)

PCT Responsibilities Before Referral

Open communication between teams and clients remains vital throughout the referral process. Suggested communication strategies from the PCT to the SCT include:

• Deliver the referral form, medical records, diagnostic test results, and diagnostic imaging by a previously agreed-upon method. Remain open to different communication strategies between teams, including email, text, fax, phone, web, or online portal.
• SCTs can help facilitate these conversations by posting fees when possible or otherwise making their prices available to PCTs.
• Use technology such as an online portal, if available, to complete the referral process efficiently as well as a place to upload relevant medical history.
• If appropriate for the case, consider teleconsulting between the PCT and SCT with appropriate fees applied.

PCTs take responsibility for providing comprehensive medical records to the SCT, such as all reports and diagnostic images, including
but not limited to radiographs, ultrasonography, computed tomography, and MRI images. To streamline this process, referral hospitals
can adopt web-based submission forms. These forms provide a structured framework, facilitating clear communication between PCTs and SCTs by outlining the necessary information required for referrals and enabling seamless transmission of patient records.

Discuss the referral process with the client, including referral care cost estimates, as much as possible. In many instances (e.g., internal medicine, dentistry, surgery cases), the PCT may not be able to provide accurate estimates prior to the SCT’s assessment. However, standardizing conversations about cost and providing at least the referral fee and any other expected tests/procedures will help clients deal with the potential stress of learning about referral costs.

SCT Responsibilities Before Referral

Referral processes differ widely across specialty practices. Standardizing the referral process is crucial because SCTs receive referrals from multiple PCTs and often see first-time clients. For instance, it may be beneficial to require that the PCT, rather than the prospective client, initiate the referral and submit the necessary documentation before the SCT reaches out to the client to schedule a consultation. Effective and timely communication on the part of the SCT before referral enhances the experience for all involved. SCT-to-PCT communication strategies include:

• A hospital webpage that clearly identifies the following information:
  • Contact information for clients and PCTs
  • Operating hours
  • Directions
  • Access to an online referral portal or other means of acquiring referral forms and providing medical records
  • List of specialty services provided
  • Photos and biographies of the SCT, if desired
• Online referral portal with pertinent information such as:
  • Regularly updated list of commonly performed services and procedures
  • Detailed cost estimates on the most performed procedures and services, including consultation fees, imaging, laboratory testing, etc., for use in discussions with clients
  • Referral roadmap

The SCT conducts a thorough review of the PCT’s provided medical records to avoid unnecessary duplication of diagnostic testing. Before arrival at the appointment, the SCT bears responsibility for fully informing clients about the necessary preparations for their pet. This includes understanding requirements such as fasting, administration of medications on the day of admission to the specialty practice, and the anticipated duration of their visit. Moreover, the SCT must educate clients on what items to bring to the appointment, particularly medications and supplements, to verify dosages and medication instructions as evidenced by the prescription label. Additionally, the SCT may advise clients to bring a 2- to 3-day supply of any special diet prescribed for their pet in anticipation of potential diagnostic procedures, medical or surgical interventions, or hospitalization.

The 2025 AAHA Referral Guidelines are generously supported by CareCredit.