If your primary care provider has recommended an eConsult, you may be wondering what happens next. Many Colorado Medicaid members are unfamiliar with how eConsults work, especially since patients do not interact directly with the specialist. Understanding the process can help you feel more confident and informed about your care.
An eConsult is designed to streamline communication between your primary care provider and a medical specialist, allowing your care team to move forward quickly without the need for an additional appointment.
Step 1: Your Primary Care Provider Submits the eConsult
After discussing your symptoms, medical history, or test results, your primary care provider determines whether specialist input is needed. If so, they submit an eConsult through a secure platform used by Colorado Medicaid.
The eConsult includes relevant clinical information such as lab results, imaging, medications, and a specific clinical question for the specialist. This ensures the specialist has everything needed to provide informed guidance.
Step 2: A Specialist Reviews Your Case
Once submitted, a qualified specialist reviews the information provided by your primary care provider. The specialist does not contact you directly or require a visit. Instead, they focus on analyzing your medical details and offering expert recommendations.
In most cases, the specialist responds within a few business days, helping avoid long referral wait times.
Step 3: Your Provider Receives Expert Guidance
The specialist sends their recommendations back to your primary care provider. These may include:
- Suggested treatment changes
- Medication adjustments
- Additional testing recommendations
- Monitoring or follow-up guidance
- Advice on whether an in-person referral is necessary
Your provider reviews this information and determines how best to incorporate it into your care plan.
Step 4: Your Care Plan Is Updated
Your primary care provider will explain the specialist’s recommendations to you and update your treatment plan as needed. This may happen during a follow-up visit, over the phone, or through your patient portal.
Because your regular doctor remains in charge of your care, there is continuity and coordination throughout the process.
Step 5: Ongoing Care Without Extra Appointments
In many cases, an eConsult eliminates the need for an in-person specialist visit. When a referral is still needed, the eConsult helps ensure it is truly necessary and better prepared.
For Colorado Medicaid members, eConsults are fully covered. There is no cost to you, and no additional scheduling or travel required.
Why This Matters for Medicaid Members
eConsults help patients receive timely, coordinated care while reducing common barriers such as long wait times and transportation challenges. By keeping care within your primary care setting, eConsults support better outcomes and a more efficient healthcare experience.
If you believe specialist input could help with your condition, ask your provider if an eConsult is appropriate for you.