Referrals
Information on Insurance Referrals
Each health insurance plan (managed care plan) has different benefits, rules and regulations. Many require you to have a referral to see a specialist. Please make sure you understand the rules of your plan.
If you have a medical concern or problem please make an appointment with our office. If you and your doctor decide a specialist referral is needed, our office will generate a referral for you. We will give you several choices of physicians or providers which we have used in that specialty. You should make an appointment with one of those providers and then contact our office, preferably through the website or by fax with appointment information. You should make sure that the provider is still participating with your insurance when you make the appointment. Our office will then generate the appropriate referral. Some are done electronically, some by telephone and others are written. Our office will need 3 days advance notice to process your referral. Emergency referrals will be done immediately.
Referrals are good for a limited amount of time and for a specific number of visits as determined by your insurance plan. If your referral expires prior to your specialist visit, you will need to contact our office for a new referral. Again, please allow 3 days.
The specialist must submit a written treatment plan to your doctor in order to receive additional referrals or visits to the same specialist. This is a requirement of the insurance company.
If your specialist orders blood work please have it done at the specialist's office or by a laboratory approved by your insurance plan. Generally, we are not able to process blood work for specialists.
Your specialist may order additional diagnostic tests. Please check with your insurance plan to see if you need specific referrals for those tests.
The referral process is required by the insurance companies. We are not allowed to make retroactive referrals or post date referrals. Our office will try to help you negotiate the process.