If you are a member of a managed care plan, there are certain procedures you must follow when accessing health care. You will work closely with you primary care physician (PCP), who will provide most of your general health care needs and coordinate expanded needs you may have such as referral to a specialist, diagnostic procedures or admission to the hospital. This relationship is very important, since your PCP will be the one provider who will manage your overall health.
Some referrals may require an authorization from you health plan before being scheduled. Your PCP’s office will generally take responsibility for securing this authorization, but please be patient. It may take up to 72 hours to obtain the authorization.
If you are unsure about whether you need pre-authorization from your health plan before scheduling your procedure or specialty appointment, please call your health plan’s member services department. You should be able to locate their phone number on your insurance ID card.