“Referrals” are written authorizations for patients who are members of managed care plans to see specialist physicians or to have certain diagnostic tests performed. In some cases, these consist of forms completed by the staff of the primary care physician (PCP). In other cases, telephone or computer authorization must be obtained from the managed care plan. We are happy to provide our patients with referrals when care is needed which cannot be provided by our own physicians or when tests need to be conducted which cannot be conducted in our own office. By reading your patient member handbook, patients can usually become familiar with the rules governing referrals provided by patient's plan or insurance company. In addition, we have adopted some policies governing referral requests here in our own office. These policies are consistent with our philosophy of providing the best comprehensive health care to all our patients. Please read these policies before requesting referrals from our physicians or staff.
Urgent/emergency referrals are prepared by dedicated staff and will be processed as quickly as possible. Routine referrals are usually ready within two business days. Follow-up calls from patients regarding routine referrals may delay this process. Referrals are NEVER “back-dated.” This is prohibited by all managed care plans. Patients who go to a specialist without a referral are responsible for obtaining a bill from that specialist, and submitting the bill directly to patient's managed care plan along with an explanation of why patient did not obtain a referral prior to the visit.
Referrals are not provided without a visit to patient's primary care physician . In many cases, patient's PCP may help avoid a visit to another doctor by handling patient's health issues directly. Although at times patients may feel that a visit to a specialist or another doctor is essential, please understand that patient's PCP bears ultimate responsibility for the outcome of your medical condition, and appreciates being consulted prior to patient's decision to visit a specialist without PCP referral. After many years in practice, we have developed a ‘roster’ of specialists whom we know and trust. In addition, most referrals to specialists authorize a single visit. Please allow us to recommend a specialist who can report back to us in a timely manner, so a follow-up plan may be organized consisent with patient's health issues.
As a board-certified Family Physician Practice , we believe that entering into a life-long relationship with our patients, makes us effective healers. If you have chosen us to be your primary care physicians, we appreciate your trust.
We understand that patients have different expectations of their primary care physician, PCP roles, and office policies. We encourage patients to discuss any issues and options , including locating another primary care physician that may be more suited to patient's needs.