The Referral Process

Different scenarios will generate the need for you to seek additional medical care from a specialist. Many insurance companies require referrals for you to see specialists or authorizations for tests and certain medications. Obtaining a referral or authorization is a time consuming process for both you and our staff. Understanding your benefits and how they relate to referrals and authorizations is essential.

father-son-nurseYou must determine if you need a written referral to see a specialist. In some circumstances, certain specialists (typically gynecologists) do not need referrals. Please review your health insurance policy. Normally you can find this information in your policy holder’s manual. If you do not have a manual, call your insurance company to obtain one. If your insurance company requires a formal referral to see a specialist, and we have not recently seen you for the problem, you will need an office visit to obtain that referral. Your insurance company requires that we establish and document a diagnosis in order to write a referral. Once you have been seen,
we will process your referral and mail you a copy. Please do not make appointments or schedule testing prior to receiving your referral.

Once you receive your referral, please read it to verify:

  • Your specialist’s name and telephone number
  • The number of visits that are approved
  • The time limits for the approval
  • When making appointments please be sure to verify the provider still takes your insurance. Provider participation changes are common and happen without notice.

Be sure to remember, we cannot backdate referrals. Please allow seven working days for our staff to process your request. When you request the referral, you must provide our office with the name of the specialist you want to see.
If your insurance company does not require a formal, written referral, you may make specialty appointments at your convenience. If you need assistance finding a specialist, a list of preferred providers is on this site. The list is compromised of local providers preferred by our physicians. When making appointments, please verify that the provider participates with your
insurance carrier.