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Precertification’s, Referrals and Authorizations

Many health insurance plans have pre-certification or prior authorization requirements for specific services and procedures. In some instances, referrals are required. Information about referrals is typically listed on the back of your healthcare insurance card. Please refer to your card, your benefits handbook, or contact your health insurance’s customer service department for more information on referral requirements.

Some important items to remember when obtaining an authorization or referral include:

  • Be certain the referral is for a service covered by your health plan.
  • The referral should be to a provider within your health plan's network.
  • Check for restrictions on the referral. For example, number of visits allowed, or referral expiration date.
  • Contact your PCP about referral requirements prior to your specialty appointment.
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