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Referrals - How To Request

Referral Bulletin

Managed Care Reform, a law that became effective on January 1, 2001, has changed the referral system in two significant ways.

1. You no longer need a referral for emergency room services.
2. You no longer need a referral for ob/gyn services.

How to request a referral

Step 1: Verify with your company that you need a referral. Even if your insurance is managed, you may not need a referral for some services. Example, most companies do not require a referral for annual or biannual eye exams, or for laboratory tests. Most companies have PPO plans that do not require referrals. Check with your company before you begin the referral process.

Step 2: Speak with your pediatrician or nurse practitioner about the need for a referral and receive medical approval for that referral. Although you no longer need a referral for emergency room visits, it is wise to call first because your pediatrician or nurse practitioner can often expedite your emergency room visit if one is necessary.

Step 3: Make an appointment with the specialist whom your provider has referred you to. When you call the specialist, be sure to ask for the specialist's provider ID number for the type of insurance that you have and the specialist's NPI number. At that time, please confirm that the specialist is a member of your health insurance network; otherwise you may be subject to "out of network" costs.

Step 4: Inform our referral coordinator of the information necessary to process your referral paperwork. You can do that in these ways:

1. Click on referral request form at the top of this page. Furnish the information requested and click on submit.

2. Pick up our Referral Request Form in our office and fill it out when you come to the office or you can mail or fax it back to us.

3. Click here for a printer safe copy of the Referral Request Form that you can fill out and mail or fax to us.

4. Call the Centre Pediatrics referral line at (617) 277-7337, option 1. Leave us your full name, your child's name, your address and your fax number if you have one. We will mail or fax to you our Referral Request Form which you complete and mail or fax back to us.

It takes approximately 5 business days to process your referral. Most referrals are now electronic, so there is no hard copy. Your specialist should be able to access your referral information via the POS devise or over the telephone. If you have questions, please contact our Referral Coordinator at (617) 735-8585.