As a part of the diagnostic or treatment plan, your primary caregiver may request consultation with a specialist. In order to proceed with the referral for consultation, your insurance company may require pre-authorization, and some plans will not pay for your visit with the specialist if you have not received authorization. Please consult your insurance plan regulations for details. Your insurance plan will notify you when consultation is authorized.
After evaluation by your provider, our office staff will notify your insurance company of the referral prior to your appointment with the specialist. Most Insurance companies will not pay for self-referral to a specialist (seeing a specialty consultant without a referral). Because of insurance regulations, we cannot do a “retroactive” referral for you.
Insurance companies almost always require that you first be evaluated by your primary caregiver for any problem which is referred to a consultant. Prior evaluation by your primary care provider ensures:
- You’ll be referred to the most appropriate consultant.
- Preliminary information will be gathered to assist the consultant.
- Further coordination of care and follow-up after your consultation.
Please contact us for an appointment if you feel you need to see a specialist. For other referral questions, our staff is available to help you. Contact our office at (360) 452-7891.