Reference

See: “Arbitration.”

Reference scheme

Theoretical pension scheme to which reference is made to ensure that members of contracted out salary related schemes post-April 1997 will receive as much in benefits as under the reference scheme to comply with PSA93, s.12B. The scheme actuary must certify that the scheme meets these benchmark requirements.

Reference scheme test

See: REFERENCE SCHEME.

Reference station

Station whose statistics are used for the purpose of calculating average daily temperatures and other meteorological variables for the purpose of weather derivatives. All such contracts are based on the actual observations of one or more stations.

Referenced diagnostic laboratory services

Diagnostic laboratory tests performed on samples that are referred to the hospital laboratory.

Referral

1. Transfer of the total or specific care of a patient from one physician to another. 2. In managed care, a request by the primary care physician for authorization for a member to receive care from a specialist or hospital or get certain services. In some managed care plans, a member may need an approval from the primary care physician to a specialist for insurance coverage. 3. Document obtained from a provider or plan-approved caregiver so that a plan enrollee may receive additional medical services from a specific place/person.

Referral (Health Insurance)

A recommendation by the insured’s primary care physician that the insured see another doctor, often a specialist.

Referral Arrangement

An arrangement between a referral company and an insurer in terms of an agreement under IRDA (Sharing of Database for Distribution of Insurance Products Regulations, 2010) whereby the agreement provides for sharing of the database of the customers of the referral company but does not include the soliciting or sale, directly or through an agent, corporate agent or an insurance intermediary including a micro insurance agent of an insurance product.

Referral authorization

Verbal or formal written document that gives approval to a managed care plan member to obtain medical services outside of the network of participating providers (e.g., primary care physician approves a plan member to see a specialist).

Referral center

Telephone service staffed by nonclinical personnel that directs patients to approved hospital facilities and physicians and may also perform triage. Managed care plans use these call centers to communicate with patients and providers and sometimes to precertify or preapprove care. Usually the center has a toll-free 800 number for easy access and no charge to health plan members. Also known as call center, 24-hour certification, or triage .