Referrals


	Understanding Referrals

It is very important to understand what your plan allows in regards to referrals. Some plans do not require referrals to be approved. Others reimburse for in-network referrals, but reimburse partially for out-of-network referrals. HMOs generally do not reimburse for out-of network referrals.


	All About Referrals

If You Think You May Need A Referral...
Call your doctor and inquire how he or she would like to handle the problem. If you know you need a referral, call the referral line and leave a message in voice mail. If the referral is not thought to be necessary, the discussion will be turned back to the doctor.

If you know you need a referral, you may also e-mail the request by using our Referral e-mail Form. We are working on ways to streamline routine referrals through the Internet. At the present time, it is a very cumbersome process for our staff to obtain referral approval from the insurance companies, making it in turn very tedious for our patients. We are attempting to rectify this problem through Internet access.


		If You Think You Need A Referral...

	Call your doctor's secretary and she will ask your doctor about whether a referral is necessary, and if so, with whom. The doctor may want to evaluate the problem before a decision is made.


		If You Know You Need A Referral...

	for situations such as a broken leg or an eye injury, you can e-mail or call the referral personnel directly (ex.228). If you are calling for a referral, please have your insurance information, the diagnosis, and the name of the doctor you need the referral for.

Be aware that the referral approval can be a very cumbersome process, sometimes taking several days of review by the insurance company. It is not just a matter of faxing forms. If you need an urgent referral, speak to your doctor (Yaffe: ext. 224; Ruden: ext. 223; Bard ext. 222; Rosen ext. 222; Balboa ext. 222). The turnaround time for a referral left on the voice mail on the referral ladies can take up to seven days.


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