If your medical condition requires the attention of a specialist, your family doctor (primary care provider, or PCP) may recommend that you see a specialist within our system. This is known as a referral. Things to remember about a referral:
- Be certain the referral is for a service covered by your Health Plan.
- The referral should be to a Provider within your Health Plan’s network.
- Check for limitations on the referral. For example, number of visits allowed, or expiration date.
Since your PCP has a broad perspective on your health, he or she will share information about related conditions, tests, or health risks with the specialist. He or she will also monitor your care if you become hospitalized.
Remember, contact your PCP about a referral prior to your specialty appointment.
Precertification or prior authorization
Information about these requirements is usually listed on the back of your health care insurance card. Please refer to your card or your benefits handbook, or contact the customer service section of your health plan to inquire about your responsibility to complete these requirements.
Call our Referral Services department.