How To Get A Specialist Referral Using Your Health Insurance PlanSunday, October 17th, 2010 by admin
Anyone who has a health insurance plan should understand the nuances of how to obtain needed coverage. That includes being able to use a specialist when necessary. Most health insurance plans do have specialist referrals but temper them with rules on how to obtain such services. Failure to follow your plan's rules with regard to referrals and specialist care can result in your claim being denied and cost you a lot of money out of pocket to pay a bill which should be covered. This article will tell you how to go about obtaining the specialist care you need. If you need the services of a specialist remember to make sure the plans available under your health insurance quotes includes this service.
Each health insurance plan usually has slight differences in what specialists are covered and how to go about obtaining the services of one within the network you belong to. This article will give general instructions for this but you may want to contact your insurance company directly to verify the information with regards to an individual company.
The first thing you need to do is notify your primary care physician of the need to see a specialist. Many people forget to do this and find themselves not covered. Those who are members of an HMO especially should not skip this step.
You may be able to skip the additional step of a visit to your primary care physician but your primary physician must issue the actual referral. Sometimes depending on the specialist and illness you will not need to visit your primary care doctor but you must always ask. If the specialist is for OB/GYN you may not need to.
Seeking a referral to see a specialist may be as easy as logging on to your insurance company's web site. Some health insurance companies have gone high tech and streamlined the specialist referrals process. If your company is one of those you may be able to get a referral simply by filling out an online form.
Once you have requested a referral for a specialist you should always call the specialist's office and verify receipt of the referral. Paperwork can get lost and it is better to make sure it arrived before your appointment so you do not get charged if the paperwork has been misplaced.
Some people may never need the added services of a specialist. However,if you do anticipate the need for specialist referrals, make sure any of the health insurance plans you look at when researching health insurance quotes include this service.