Who needs a referral to see a specialist?
Patients with Medicaid or Medicaid plans, HMO plans (such as Kane County IPA, Union Heath, Blue Cross HMO), and other plans.
It is the patient responsibility to know if their insurance requires referrals.
How referrals work
A referral is approval from your insurance to see a specialist or provider other than your primary care provider, our office requests a referral from your insurance. It is important to understand we do not have control over the specific specialist your insurance approves. For example, the insurance typically will only approve a specialist in their network so you may be referred to a specialist in Chicago even though there may be a similar specialist closer to our area.
If your plan requires a referral and you don’t get one first, your insurance won’t cover the cost to see the specialist and you would be responsible
We ask that you notify us as soon as you are aware you need a referral. Once your referral is approved you will be notified by our office.
If your specialist recommends that you see another specialist, you’ll need to contact our office for an additional referral.
Who Do I Contact If I Need a Referral?
if you have a portal account you can request your referral online at any time.