0
The answer depends upon the nature and terms of your health plan. Plans run the gamut from very limited health maintenance organizations in which you select a primary care physician where he/she has to OK all referrals to specialists, to others where you are given more latitude to seek specialized care. Most all of them allow specialized care, but have a series of approval steps that must be taken to do it correctly.
The best bet if you have a question is to contact Customer Service at the health plan and determine the proper procedure. There is likely a toll-free number on your membership card. If you do not follow the rules concerning pre-authorization, the penalty could be that the plan will not pay the charges even if they may have otherwise been covered and payable.
Wiki User
∙ 13y ago
Add your answer:
Earn +20 pts
Does medicare person need referral to see a dermatologist?
No they do not. You may go to a dermatoligist anytime without a referral. As a dermatologist, I see people many a time without referral, and all dermatologists can bulk bill payment, and send them to medicare.
Where can I find the names of liposuction doctors in the Bedford, New York area?
You can ask you family doctor for a referral. Legally you will need a referral from your family doctor before the specialist will see you.
Do you need a referral to go to a thyroid specialist?
In order to see an endocrinologist, who specializes in thyroid conditions, you might need a referral. A lot depends upon whether you're newly diagnosed with a thyroid condition and/or your insurance provider.
How do I know if I have an internal allergy?
Your first step would be to go to a local doctor. They can run some test for you. If it is determined that you need to see an allergy specialist, you should be able to easily get a referral.
What type of doctor do you see for pain in the kidney area?
Start with your primary care provider, who can do initial screening and referral to determine the most practical specialist and to get some of the initial testing done before you see the specialist.
What is the difference between referral and authorization?
A referral is a recommendation from a primary care provider to see a specialist or receive specific services. An authorization is approval from an insurance company for medical services or procedures to be covered. In short, a referral directs you to a specific provider, while an authorization confirms payment coverage.
What kind of doctor should I see if I need treatment for vertigo?
If you are close to a rural area, then contact a neurologist ( ear , nose and throat specialist) and make an appoitment. If you need a referral or are not close to a neurologist, contact your primary care physician.
What type of doctor is for ringing in ears?
You will probably have to see a general practicioner first to get a referral to an ear, nose and throat specialist.
How long is a doctor referral to a specialist good for?
normally 6 months
What kind of doctor should i see reguarding mass on rib cage?
Just go to a general practitioner, and they will be able to give you a referral to the correct specialist.
A long time patient comes to medical office without the necessary referral in handhow would a medical assistant handle this situation?
Are you talking about a specialist? Call the primary physician that referred the patient and ask for a referral to be faxed. Otherwise, do not see them.
What are the benefits of CareFirst BlueChoice program?
The benefits of CareFirst BlueChoice program is that the user will not need a referral to see a specialist, you get 365 days of coverage for hospitals, you don't have to file a claim form, you get discounts on dental care and you get preventative care and wellness benefits.
