Many doctors do not offer diagnostic tests or procedures in their clinics. They refer their patients to a facility where professionals skilled in the respective field conduct these tests or procedures, the results of which are provided to the doctors. The services that these facilities provide are called ancillary services. They are supplemental healthcare services provided by professionals other than doctors and surgeons. These service providers are an important part of the healthcare sector. The different types of ancillary services include diagnostic, therapeutic, and custodial. Ancillary services can be provided in a medical office, an ambulatory service center, a freestanding diagnostic center, or a hospital. In a hospital, ancillary services can be provided in its different departments. These services can be provided in a private office outside the hospital if the professional has all the equipment and machines available. Ancillary services can also be provided in a freestanding facility like a laboratory or therapy clinic. The in-office ancillary services have led to faster diagnosis and treatment of patients, helped improve skillfulness in healthcare, and urged patients to act in accordance with their healthcare provider's treatment recommendations. There are rules for ancillary service providers in many places. They cover the skilled personnel performing the service, the equipment which is used, and the services that are required. Ancillary service providers are bound by the same rules and regulations as the primary providers. They must be able to maintain a satisfactory service performance according to the ARRA of 2009 or face severe punishments for the same. Described below are the various types of ancillary services in healthcare. ▸ Diagnostic ancillary services bring about timely, cost-efficient, and high-quality care. These services include x-ray services, ultrasounds, Doppler testing, clinical lab services, audiology, vision repair solutions, chiropractic services, dental services, radiology, radiation oncology, pulmonary testing services, and others. ▸ A diagnostic service can be carried out only when the doctor has told the patient that he or she needs a specific test to be done. It is provided to help a physician know about a patient's medical condition or health. ▸ Diagnostic services are also useful when the patient is following up with the provider regularly for the particular medical condition to know how the treatment is going, based on the reports of the previous visits. For example, if a diabetic patient is making a follow-up visit, he will know how the medicines are working, based on the previous reports. ▸ Under the therapeutic ancillary services, services such as speech therapy, occupational therapy, physical therapy, psychotherapy, cardiac rehabilitation services, transportation services, cosmetic services, nutrition education, and others are included. ▸ A speech therapy is given to a patient with communication and swallowing disorders. The therapy improves the patient's understanding and expression of language. The services provided by the therapist must be suggested by a physician and agreed by the insurance company. ▸ Occupational therapy is a treatment given to develop, maintain, and normalize the daily activities of an individual. These therapists develop a plan of treatment to improve independence in everyday activities. They may recommend special equipment that would help the patient gain independence. Occupational therapists usually function with experts in physical therapy, speech therapy, nursing, social work, and the community. These therapists start with the treatment after referring a physician and making sure that the insurance company has accepted it. ▸ Professionals involved in physical therapy help improve mobility and treat injuries of patients. Injuries may include those of the knee, shoulder, or back. A physician has to suggest physical therapy to the patient and the insurance must agree with the service. ▸ Psychotherapists are professionals who identify and resolve troubled thoughts, feelings, and behavior concerns of a patient to improve his well-being, and so that the patient can function well. This therapy is used to treat depression, anxiety, phobias, and abuse. ▸ Cardiac rehabilitation services or cardiac rehab programs are those which help patients to recover from heart attacks, heart surgery, and others. These programs provide education and counseling services to improve the physical fitness of patients and reduce the risk of heart problems. They can be given only when a cardiologist tells a patient that he needs a session on cardiac rehabilitation and when the insurance company agrees with the service. ▸ Cosmetic services involve surgeries which change the appearance of a person. They include facials, botox treatments, skin care advice, and others. ▸ Transportation services are provided by hospitals to carry the patient from one hospital to another. They may also provide patients with transportation to their home or elsewhere. ▸ In a hospital, a dietary assistant provides a menu to each patient from which one can select meals. Dietary education is given to people so that they receive proper nutrition. These assistants work with the medical staff to make sure that the patient's nutritional needs are met on a daily basis, depending on his or her medical condition. ▸ Custodial services involve the care and support to a patient who is unable to perform daily work without external help. This non-medical care helps the patient to carry out activities such as bathing, eating, dressing, and others. ▸ Custodial ancillary services focus on living accommodations, home health, or nursing home care. ▸ Nursing homes that provide custodial care are also an example of ancillary services. Custodial care providers do not need specialized training. Ancillary services are growing very fast because they are cost-effective and the providers are delivering high-quality services. Moreover, they are a crucial part of healthcare. These services can be provided at a lower cost and they let the doctors access the information they require to diagnose and treat a patient's health condition. Using ancillary services to provide more help to patients is a growing trend among physicians. According to Medscape's 2013 Physician Compensation Report, physicians are thinking of ways to create greater revenue by introducing ancillary services to organizations. The ancillary service sector is one of the fastest developing sectors of healthcare. It is a very important segment of the healthcare delivery system. With the expensive treatment procedures and medicine costs on the rise, ancillary service providers are a cost-saving alternative to outpatient hospital and physician services.