Specialty Referrals

ACT/Behavioral Health

• Be sure to include good contact numbers
• Include a statement indicating that the patient agrees to talk to Behavioral Health.

Colonoscopies/EGDs

• For CS/EGD procedures to be done in Bethel,
  • Refer to Adult Surgery Internal (YK Colonoscopy)
  • Refer to Adult Surgery Internal - YK EGD
• For CS/EGD procedures to be done at ANMC
  • Refer to Adult Surg Ext (only EGD/CS), not Gastroenterology.
  • There is no ANMC Surgery Internal Referral.

Dental

• All referrals are processed through YKHC Dental Department.
• Referrals to ANMC must be processed through YKHC Dental.
• If you have acute dental concerns, you can TigerText "Dental On Call" or send your patient to Dental for a walk in clinic appointment. It is not necessary to place a referral to dental.

General Surgery

You do not need to call the surgeons in Anchorage to order a surgery referral. That being said, it is a good idea to call them if you are not sure what the patient needs.

Anyone needing to be seen by surgery will need an accepting physician so you will have to contact the surgeon on call at ANMC (1-907-663-2662) and ask for the on call surgeon. Discuss with the surgeon whether the patient is best suited to be seen in Bethel or Anchorage. Make sure to document the name of the surgeon on the referral.

Orders Available

• Refer to Adult Surg Ext (no EGD/CS)
• Refer to Adult Surg Ext (only EGD/CS)
• Refer to Adult Surgery Internal - YK EGD
• Refer to Adult Surgery Internal - YK General
• Refer to Adult Surgery Internal (YK Colonoscopy)

ANMC Adult Surgery Referrals

• order: "Refer to Adult Surg Ext (no EGD/CS)"
• Stages

1. CM in Bethel collects information and sends it to Anchorage.
2. CM in Anchorage reviews the information and presents it to a provider.
3. The provider makes a decision.

If they need more information, it goes back to step one and you get a message from the CM to get more information. If you call first, you can provide the information they need and get the patient the right care faster.

Colonoscopy

• If the patient can be done in Bethel, order: "Refer to Adult Surgery Internal (YK Colonoscopy)"
• If the patient cannot be done in Bethel, order: "Refer to Adult Surg Ext (only EGD/CS)"
• If you are not sure, contact the on-call anesthetist or Dr. Compton.
• The queue is managed by the Surgery Case Manager.

To screen for colon cancer when the patient cannot do a colonoscopy

• The provider orders the test.
• The patient picks up the test from the YK lab or a village clinic. If the village clinic does not have a test, the YK lab will send a test to the village clinic for the patient to pick up.
• The patient collects the sample per instructions.
• The patient brings it back to the village lab or the YK lab.
• The specimen is transported to the YK lab by policy.
• The YK lab runs and results the test.

EGD

• If the patient can be seen in Bethel, order: "Refer to Adult Surgery Internal - YK EGD"
• If the patient cannot be seen in Bethel, order: "Refer to Adult Surg Ext (only EGD/CS)"
• If you are not sure, contact the on-call anesthetist or Dr. Compton.
• The queue is managed by the Surgery Case Manager.

Vasectomy or other minor procedures to be done in Bethel

• Order: "Refer to Adult Surgery Internal - YK General"
• The queue is managed by the Surgery Case Manager.

For Everything Else

• Order: "Refer to Adult Surgery External (no EGD/CS)"
• The surgeons will decide whether to see the patient in a Bethel field clinic or in Anchorage.

OB/GYN - Surgery

Orders Available

• Refer to OB/GYN Surgery Internal Cleared
• Refer to Gynecology External
• Refer to Gynecology Internal

General Information

• If you have talked to Dr. Compton and he says the patient needs surgery in Bethel, or the patient wants a tubal ligation, order: "Refer to OB/GYN Surgery Internal Cleared"
• Dr. Compton is available by phone at most times (907)545-0596.
• This puts them on the queue to be scheduled for surgery.
• This queue is managed by the Surgery Case Manager.

GYN - Bethel

• Almost all referrals should start here as most insurance will require that the patient be seen locally first.
• For patients who you want to be seen in a Bethel clinic, order: "Refer to Gynecology Internal"
• The queue is managed by GYN Case Manager.

GYN - Anchorage

• For patients who you want seen in Anchorage, order: "Refer to Gynecology External"
• The queue is managed by GYN Case Manager.

Optometry/Ophthalmology

• All referrals are processed through YKHC Optometry.
• Referrals to ANMC must be processed through YKHC Optometry.