**3. Processes**

### **3.1 Referral system**

Slovenia operates a gatekeeping system whereby patients require a referral from their family physician in order to access specialist care. Family physicians may refer their patients to a particular outpatient specialist or to hospital diagnostics and treatment units. Physicians may also advise patients on which specialist or institution they would recommend, but, ultimately, patients make the final decision themselves. Patients can choose their secondary or tertiary provider anywhere in the country every time they are given a referral. Specialist services without referral by family physician are paid out of pocket. The same goes for family physicians and other private providers without contract with HIIS or for those services not included in the basic benefits package covered by the compulsory insurance scheme. If patients select a private provider who does not have a contract with the HIIS, they are required to cover the cost of these services in full themselves [11].
