How can I get medical treatment set up if the clinic says they need a referral letter or imaging records first? – North Carolina

Short Answer

In North Carolina, clinics often will not schedule certain specialists, physical therapy, or advanced imaging until they receive (1) a referral/order from a treating provider and (2) prior imaging reports or records. The fastest path is usually to start with an urgent care, primary care provider, or emergency department visit to document symptoms and obtain the referral/order, then sign a records release so the prior provider can send imaging and notes directly to the new clinic. An attorney can also help by sending the clinic a records authorization and coordinating record collection so treatment is not delayed.

Understanding the Problem

In North Carolina after a motor-vehicle accident, an injured person can have real pain but still get “stuck” because a clinic will not book an appointment until a referral letter or imaging records arrive. The decision point is simple: can treatment be scheduled now, or does a referral/order and prior records need to be obtained and delivered first. This issue often comes up when back or hip symptoms suggest a need for a specialist visit, physical therapy, or an MRI, and the clinic’s intake staff requires documentation before opening the schedule.

Apply the Law

North Carolina law treats medical records as confidential. Providers generally release records only with the patient’s authorization (or a legal representative in limited situations). That means a clinic that “needs records first” usually cannot pull them on its own unless the patient signs the right release, and the prior provider then sends the records. In practice, the “referral letter” is typically a written order or request from a treating provider explaining the reason for the visit or test and what is being requested (for example, a physical therapy evaluation or an orthopedic consult). If the injury happened at work and the claim is handled as workers’ compensation, different rules can apply to how treatment is authorized and paid.

Key Requirements

A treating provider visit that creates the referral/order: A clinic usually wants a current provider to document the symptoms and request the specific service (specialist visit, PT, MRI, etc.).
A signed medical records authorization: Because records are confidential, the prior provider typically needs written permission before sending imaging reports, radiology discs, and visit notes to a new clinic.
Delivery and confirmation: Records must reach the correct fax/portal/address and be matched to the correct patient chart; scheduling often will not move forward until the clinic confirms receipt.

What the Statutes Say

N.C. Gen. Stat. § 8-53 (Communications between health care provider and patient) – Treats medical information as confidential and generally requires patient authorization (or a proper legal process) before disclosure.
N.C. Gen. Stat. § 131E-97 (Confidentiality of patient information) – States that facility medical records are not public records and are protected.

Analysis

Apply the Rule to the Facts: Here, the reported back and hip pain suggests a need to start documented care promptly, but treatment has not started because the clinic wants a referral letter or imaging records first. Because medical records are confidential, the clinic typically cannot obtain prior imaging without a signed authorization, and it may not schedule until it receives both the referral/order and the records. The letter stating there is “no medical treatment” is a common red flag in injury claims and usually means the claim file does not yet show documented care, making it even more important to get treatment and records organized quickly.

Process & Timing

Who initiates: The injured person (or the attorney with written permission). Where: The prior provider’s medical records department and the new clinic’s intake/scheduling department in North Carolina. What: A signed medical records release/authorization and a written referral/order from a treating provider. When: As soon as the clinic requests it, because scheduling often will not open until the documents are received.
Get the referral/order: If there is no current treating provider, schedule an urgent care, primary care, or emergency department visit to document symptoms and request the needed referral (for example, orthopedics, physical therapy, or imaging). Ask the provider’s office to send the referral directly to the clinic and to provide a copy for personal records.
Collect and transmit imaging/records: Request both (a) the radiology report and (b) the actual images (often provided on a disc or via electronic sharing). Confirm the clinic’s preferred method (fax, portal upload, or direct electronic transfer) and then call to confirm the records were received and attached to the chart so scheduling can proceed.

Exceptions & Pitfalls

Wrong office, wrong fax, or incomplete request: Many delays happen because the request goes to the wrong department or asks only for “records” but not the imaging disc/report. Getting the clinic’s exact intake instructions and using them matters.
Referral vs. prescription confusion: Some clinics mean a formal referral; others need an order (for PT or imaging). Clarifying what document is required avoids repeat trips and resubmissions.
Gaps in treatment documentation: Insurance letters that say there is “no medical treatment” often signal the claim file lacks proof of care. Delays can create disputes about whether the accident caused the symptoms, so documenting symptoms and starting appropriate care promptly is important.
Work-related injuries: If the crash occurred in the course of employment, workers’ compensation rules may control authorization and payment for treatment, and the steps can differ from a standard auto claim.

Conclusion

In North Carolina, clinics commonly require a current referral/order and prior imaging or records before scheduling certain appointments, and those records usually cannot be released without written authorization. When back and hip pain is delaying care, the practical solution is to obtain a treating provider visit that generates the referral/order and to sign a records release so the prior provider can send imaging and notes directly to the clinic. The next step is to submit the authorization and referral to the clinic’s intake department and confirm receipt so scheduling can move forward.

Talk to a Wrongful Death Attorney

If a clinic is delaying care after a crash because it needs a referral letter or imaging records first, our firm has experienced attorneys who can help coordinate records requests, communicate with providers, and explain timelines that can affect an injury claim. Call us today at [919-341-7055].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.