Referrals
Referral Procedure
You consult with your PCP about your need for a referral. Depending on the reason for the referral, your doctor or you may initiate this conversation.
Requests for referrals outside an office visit for a new problem or an existing problem you have not been seen for recently require an office visit. This is important because your provider needs to ensure you get the proper care from the right specialist at the right time. Many specialist offices require specific updated records and tests to determine medical necessity, Insurance coverage, and parameters of your consult. If the provider does not have relevant updated information, we must schedule an office visit
If you need to request a referral, please call our office at 559-625-9200 with the following information:
• Specific issue and/or symptoms, and we can schedule an office visit
If you have a specialist name in mind, please have the name at the time you book your appointment
• Phone number and address
Some Specialties have multiple locations – please ensure we know where you want to be referred
It is your responsibility to check if the specialist you wish to see or if the services you are requesting are covered by your insurance. Please be aware that some specialist offices require a referral even if your health insurance doesn’t require one. Referrals can take up to 2 weeks to process.
Why does my referral take time?
Insurance sometimes takes time to authorize your referral
We may be waiting on test results or imaging needed to complete your referral
We may be waiting on Specialties to return our call regarding case specifics
Specialty offices have their time frames for processing referrals
Failure to provide the most recent information, such as Insurance Contracts, ID Cards, and contact information, may delay your referral.
Insurance Contracts and requirements are constantly changing; our office may not be privy to specialty office contract changes with your insurance in real time.
What to Expect from the Referral Coordinator:
• Process Referral(s): Submit referral to specialty providers along with the patient’s medical history or pertinent medical information.
• Insurance Authorization: If the patient's health insurance requires it, obtain necessary insurance preauthorization from a specialist.
• Referral Tracking: Follow up with specialists and patients after thirty days to ensure an appointment was scheduled successfully.
Help with referral follow-up: Please feel free to call our office or referral clerk if you are experiencing difficulty obtaining an appointment. We cannot schedule appointments for you, but we can help you navigate any difficulties you may run into.
What we expect from you :
Appointment: Please ensure you have had a recent appointment relating to your request.
Contact Information: Do we have your updated contact information? If not, this will delay the referral process.
Insurance: Do we have your most recent insurance information on file? This is important because each plan has its own unique set of conditions for referrals. Copies of Cards are super important. Some specialty offices require the actual physical copy of the card.
Follow Through: When you schedule an appointment with the specialist we referred you to (we request you do so within 30 days unless otherwise directed by your provider), it’s important to make every effort to get there. Some specialists will not re-appoint you if you are a “no-show” or reschedule too many times.
Ask questions: We send our referrals via fax and get confirmation from the office that they have received them. Please call the office we referred to you first.
If an office states we did not send it, this may be an oversight on the specialty side. We may also be waiting for additional information. Please call our office so we can determine if additional steps need to be taken.
Thank you for being a patient at Visalia Family Practice. We look forward to providing you with the highest quality care possible.