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Referral Process at
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If your doctor has referred you to a specialist or to have a test, please see details below of PrimeCare’s referral process.

If it is easily determined that no authorization from your insurance company is needed, the process is as follows:

  • The appointment may be scheduled by our check-out personnel.
  • The paperwork is processed to schedule the appointment.  The length of time that this takes depends on the office that you are being referred to.  There are several offices, in which, it takes a few days after the paperwork has been received, for us to actually secure an appointment.
  • Once the appointment is scheduled, you will be contacted with the referral information. 

If it is not easily determined whether authorization is needed, then the process is as follows:

  • Paperwork for the authorization request will be completed by your doctor.
  • Once our authorization department receives the paperwork, they contact the insurance company according to the order in which they receive the authorization request. 
  • There may be a few days of back and forth “phone/fax tag” with the insurance company.
  • If it is determined that no authorization is needed, the paperwork is then processed to schedule the appointment and you will be contacted with the referral information.  The length of time that this takes depends on the office that you are being referred to.  There are several offices, in which, it takes a few days after the paperwork has been received for us to actually secure an appointment.
  • If it is determined that authorization is required, the insurance company has up to 7 days to get back to us with an authorization number. Only after we receive the authorization number are we able to complete the process by contacting the office where the appointment will be scheduled.  As explained above, the length of time that this takes depends on the office that you are being referred to.  There are several offices where the process takes a few days after the paperwork has been received, for us to actually secure an appointment.
  • Authorization requests labeled “URGENT” or “ASAP” by the doctor are processed immediately.  The insurance company may take 24 hours to provide the authorization.  All other requests will be handled according to the order in which they are received.
  • Once the appointment is scheduled, you will be contacted with the referral information.

Please make a follow up appointment with your primary care doctor if he/she has requested you to do so.

Be sure referral to the specialist and/or tests have been completed prior to any follow up appointment.

 

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