18 Apr 2016
- By Bryan Manabat - firstname.lastname@example.org - Variety News Staff
RONALD Sablan, the medical referral services director, has informed Variety that Verona Resort & Spa on Guam will not be getting new patients from the CNMI until it has been inspected “and we are satisfied with the quality of its rooms.”
But he said current referral patients who are satisfied with Verona’s accommodations will be allowed to stay there.
“We are sensitive to the needs of our CNMI patients — some of them have been staying there for a long time now and are in need of kitchenettes that only a few hotels in Guam provide.”
A CNMI medical patient referred to Guam earlier complained about the uncleanness of a room provided to her by Verona.
Asked how CNMI medical referrals are approved, Sablan replied: “Identifying a medical condition is the first step in the process.”
He said it is a CNMI-based physician who identifies a patient with a medical condition requiring medical care and treatment outside the commonwealth due to unavailable medical specialists or equipment on island.
“The referring physician will then complete the referral package attaching the patient’s medical history and condition,” Sablan added.
This medical referral application is forwarded to his office for data input and record filing and reviewed by a medical referral committee, he said.
An approved referral package will be given a case number and assigned to a medical referral coordinator, Sablan added.
Deferred or denied cases are returned to the referring physician with recommended actions.
Sablan said a medical referral services coordinator assigned to the approved case starts the referral process by requesting an appointment confirmation from the closest recognized available medical provider based on the patient’s medical condition and insurance carrier.
While waiting for an appointment confirmation date, administrative and financial documentations as required by the rules and regulations are gathered, Sablan said.
“Once the appointment is confirmed, our coordinator will check with the Department of Finance for funding authorization, including lodging for patients and escorts as authorized by the [medical referral] committee.
“Transportation, lodging, follow-up appointments and other patient and escort needs will be coordinated by the CNMI medical referral offices on Guam, Hawaii/continental U.S. or a contracted medical provider in the Philippines as soon as funding is authorized.
“Hotel accommodations are actually ‘blocked’ to assure that once there is an approved medical referral there will be available lodging for them.”
According to Sablan, an official medical treatment authorization is issued prior to the patient’s departure.
“The authorization will have the signatures of the designated medical provider, departure date, case worker, reference number, travel authorization, accepting physician, referring physician, patient’s information and diagnosis and list of parties responsible for adjudication.
“The medical referral services coordinator assigned monitors the patient progress and updates the medical treatment authorization for additional treatment recommendation with approval until the patient is discharged. The coordinator follows treatment protocol as specified on the discharged summary for continual care.”