Referral Process


 

Patients with HMO insurances are required by their insurance to see their primary care providers. When necessary, patients may be referred to specialists, radiology or other testing. Except for a few HMO insurances, patients will need an electronic or handwritten referral. Other times a prescription is the only referral completed. This is dependent upon the patient’s needs for further treatment and the type of insurance the patient carries.

If a particular test is ordered by the primary care provider, (MRI, CT scan, PET scan or nuclear study) the Referral Coordinator sends a request for special approval to an area hospital or radiology center. The special approval is called “prior authorization”, also known as “precertification” or pre cert for short. If a patient is unsuccessful in finding a specialist that accepts his/her insurance, our Referral Coordinator will be able to assist in locating a participating provider. In addition, the Referral Coordinator is also able to assist patients in setting up the actual appointment in either English or Spanish.

To speak with our Referral Coordinator, please dial (610) 326-9460, option #4.