What if my insurance plan requires a referral and/or a prior authorization?
A. If your insurance company requires a referral and/or prior authorization, contact your primary care physician prior to seeing a specialist. If your insurance company requires a referral and/or prior authorization and you do not have one, you may not be seen for your scheduled appointment, or you will be responsible for full payment of your bill at the time of service. If your specialist requires more visits than your insurer approves or if the referral has expired, you must contact your primary care physician for another referral and/or prior authorization.
Related Questions
- The member’s primary insurance requires prior authorization for inpatient rehabilitation and so does CareSource. Do I need to obtain prior authorizations from both plans?
- My insurance company requires a prior authorization before they will cover the cost of my medication. What does that mean?
- What if my insurance plan requires a referral and/or a prior authorization?
