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When a patient's family physician cannot provide a medical treatment, the patient may wish to see a specialist. This document allows you to request that your primary care physician (i.e. your family physician) refer you to a specialist. Your physician may ask that you come in for an appointment before he or she makes the referral. Alternatively, your physician may suggest that you see a specialist without you requesting him or her to do so.

Nearly every insurance company and managed care organization has its own policy regarding referrals to specialists. For example, many health care plans require a patient to obtain a referral from his or her primary care physician before seeing a specialist. Additionally, some specialists will not see a patient without a referral.

However, in some instances, a referral may not be necessary. For example, many companies or managed care organizations allow a woman to visit a gynecologist for an annual exam without a referral. This should be explained in your insurance policy or other benefits information.

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14y ago

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