Referrals
Steps to a Successful Referral
When your provider recommends seeking out a pediatric specialist, they will refer you to a physician usually from a nearby teaching hospital. Depending on your insurance plan you may or may not need an authorization for the referral –
your provider will not know this and it is your responsibility to get this information from your insurer. You will also need to verify that this specialist is in network prior to the visit.
- Check with your insurance company to see that the specialist to intend to see is a participating physician in your plan.
- Our referral coordinator will make or help you make your appointment and verify that the specialist is still a participating provider with your insurance. Do this even if the appointment you are making needs to be expedited by our staff or still needs an authorization or referral form. By doing this you get your name and information into their computer systems.
- Some insurance companies require a referral form that must be generated by our practice. Verify this with your insurer.
- If your insurer requires a special referral form, contact our office with the following information:
- name of specialist
- phone number of specialist
- your appointment time and date
- Before being seen you should have received a copy of the referral by mail or if you had requested it to be faxed to the specialist, verify that the specialist has received it. In many cases we cannot backdate the referral. Please note that any charges due to the lack of a referral will be your responsibility as per the insurance company.
