Referral - The directing of a patient to a medical specialist by a primary care physician for further evaluation, testing or treatment.
Pre-Authorization - A decision of medical necessity by your health plan for health care services, test, treatment or equipment; sometimes these are called, prior approval or precertification. Pre-Authorization needs to be initiated and approved before services are rendered and are not a guarantee of payment.
Referral request can be submitted via your Follow My Health Patient Portal account and is the best way to communicate with our referral coordinator.
Referrals and pre-authorization can take up to 7-10 business days.
Approvals are usually only valid for a specific amount of time. They also may require periodic renewals. If you receive a referral or pre-authorization for health care services and do not schedule it during the approval time frame it may not be covered or paid for by your health care plan. We will also need to resubmit the request. Renewals and reauthorizations will work the same as an initial prior authorization requests and can take up to 7-10 business days.
* Copies of your referrals and insurance authorizations can be found in your FollowMyHealth Patient Portal account under the My Health - Documents section.
If you have any futher questions in regards to this process, please feel free to contact our Referral Coordinator, Ashleigh at (847) 395-3322 ext. 115.