FAQ on Referrals and Authorizations
What is a referral?
How do I know if I need a referral? Do I need a referral to see an ENT specialist?
You need a referral only if your insurance company requires you to have one. Typically HMO plans require a referral/authorization, however the best way to know for sure is to contact your insurance company before you make an appointment with a specialist. The phone number is located on the back of your insurance card. Some insurance cards state on the card whether or not you need a referral/authorization.
How do I get a referral?
How does my referral get from my PCP to the ENT specialist’s office?
What happens if I don’t have a referral the day of my appointment?
Unfortunately, if your insurance company requires a referral and you do not have one, they will not pay the claim for your visit and the patient or patient’s parents will be responsible for the bill. Therefore, we cannot see the patient without a referral, unless they sign a referral waiver and agree to pay in full at the time of service.
Do I have to get a referral every time I come see a specialist?
Every referral has an expiration date and number of allowed visits. If you need to come back to the specialist after the expiration date or for more than the specified number of visits, you will need another referral from your PCP. For example, the referral may be good for one year but only allows two visits; therefore, if you need to see the specialist for a third visit, you will need another referral.
We're Ready to Assist You
Relief from ear, nose, and throat disorders is closer than you may think!
If you’d like to schedule an appointment, contact our office by phone or reserve an appointment online. Our practice locations are in the Trinity and Wesley Chapel areas of Pasco County, making quality care easily accessible. To meet the evolving needs of our community, we’re also pleased to offer convenient ENT telehealth appointments that allow patients to consult with our professionals from the comfort and safety of home.
