A referral is a recommendation made by your Primary Care Provider (PCP) to see a different provider or specialist who can provide services typically outside your PCP’s scope of practice. Your PCP will issue a referral when needed, and once it’s issued the referral can be mailed, picked up by the patient or sent through the Patient Portal so the patient can schedule their appointment with the specialist.
Pre-authorization is a review to determine coverage for your specialized medical service and to verify the need for this service by your insurance company. Pre-authorization may be requested before any services can be provided. It takes approximately 7-10 business days to get pre-approval. If the referral is denied the insurance company will send a letter to the patient stating, why the authorization was denied. Our Referral Coordinator will submit your referral for pre-authorization if necessary.
If you have any questions regarding Referrals, please call: 773-364-2300