Referral Process

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How do I make an appointment with a specialist? Do I need a referral?

If you have a PPO insurance plan, you don't need a referral to a specialist for an initial consult. You may need referrals for tests and procedures, depending on your health plan. You can visit any doctor in or out of your network, though copays for out-network doctors are generally higher. If you have an HMO insurance plan, you will need to get a referral from your primary care physician (PCP) before seeing a specialist, otherwise your insurance may not pay for the visit. Your PCP can provide you with a referral.

How long should it take for my referral to get processed?

Processing times may vary based on the urgency of the treatment or necessary imaging requests needed However, for routine treatments we typically target a turnaround of 5 business days for HMO referrals. Procedures and tests that require referrals for PPO patients may take up to 14 business days for processing.

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