What is a referral and why is it important?

• A written request from your child’s provider to another provider or service, who can diagnose or treat your child for a particular condition
• It indicates the need for you to take action to connect with a specialist or service within a specified time indicated by your child’s provider.
• It may be required by your insurance to cover services needed.
• It may be given to you by your child’s provider, or you may request one for a specific need or second opinion.

Your health professional might refer you to someone else if:

• Your child needs care, treatments, or tests from a specialist or a specific service

How long does a referral last?

• Most are limited to 12 months.
• Your child’s provider can let you know if the timeframe is different.

What happens if you visit a specialist without a referral?

• Some specialists might not see your child, or it may delay your visit.
• You would need to provide the specialist with medical records and other requested information that can be complex and difficult to gather. If your child’s provider gives you a referral, they take care of gathering necessary documents and information for you.

If you have questions about your insurance coverage, contact our financial services department.