As family physicians, we take care of most of your health care needs right in our own office. However, as we fulfill our goal to provide our patients with the best health care possible, we may at times recommend consultation with a subspecialty physician. Your primary care physician (PCP) can direct you to a qualified specialist affiliated with a local practice within our referring service network. Coordinating your care with specialists with whom we most closely communicate results in better quality of care and increased efficiency. Infrequently, if an appropriately specialized physician does not exist in our usual network, your PCP will refer you to a physician outside the network.
Many health insurance plans will not pay for referred doctor visits that have not been approved by your PCP in advance.
When you make your appointment with a specialist recommended by your PCP, it is your responsibility to contact our office to request the appropriate insurance referral.
Please follow these guidelines to help in the processing of referrals:
- Please allow your PCP to coordinate your care; do not self refer to specialists.
- If you feel there is a reason to seek the care of a physician outside of our local network, please make an appointment with one of our providers to discuss your concerns.
- If your PCP does not agree with the necessity of a self-referred specialist appointment and does not approve the referral, you will be responsible for payment to the specialist.
- If you are unable to get an appointment with a PCP-recommended specialist within a reasonable period of time, please contact our office; we will help you get the appointment.
- Please contact our office at least 7 business days prior to the specialist appointment to allow sufficient time for reviewing and processing.
If you have any questions or concerns regarding our referral policy, please call your FMA office.