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Is authorization needed for referrals to specialists?

April 26, 2017Authorization needed referrals specialists

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Is authorization needed for referrals to specialists?

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A referral is required for CareSource members to be evaluated or treated by most participating specialists. A Prior Authorization is needed to refer a member to an out-of-plan provider. Specialist-to-specialist referrals are generally not permitted. Care should be coordinated through the PCP. Please see Section 7 of the CareSource Provider Manual for more details.