Referrals
At The Noe Valley Clinic, we’re well-equipped to manage most of your medical needs from general preventive care to acute illness, injury and chronic disease. Nevertheless, there will be times you may need to see a specialist. Though insurance rules are often complex and evolving, here are some recommendations we can offer to make your referral process much simpler.
- 1. Complete your Personal Health Summary
If you haven’t yet done so, we recommend you complete your Personal Health Summary (PHS). This will allow us to have a complete picture of your medical health and allow you to share that information with the specialist of your choice.
- 2. Determine if you need to be seen by a specialist
If you are unsure if you need to see a specialist, then it’s probably best to just schedule a visit with us at The Noe Valley Clinic. We can address your issues 90% of the time on the same-day. And it beats having to wait several weeks for an appointment with a specialist.
If you have a specialist who you regularly see about a rare or complicated issue, then it’s probably fine to go straight to that specialist. Read the next section on health insurance rules to determine what you should do next.
- 3. Confirm your health insurance type and rules
Check your insurance card and determine what kind of insurance you have.
Most patients with PPO insurance do not need a referral. If that’s the case, simply find a physician you want to see and schedule an appointment with that physician. Often, your health plan will have a directory of approved specialists so check that first.
If you have HMO insurance, then you will probably need a referral from us as your primary care physician (make sure you have selected one of us as your primary care physician; otherwise, the referral may be denied and you may be charged by your health insurance company).
If you have a specific physician you want to see, check with your insurance plan to make sure he/she is “in-network” or covered by your HMO. If you don’t care about who you see, then we can refer you to an HMO provider that we work with regularly.
- 4. Send us an e-mail
If you have determined that you have HMO insurance and would like to see a specific specialist who accepts your HMO insurance, then please e-mail us the following:
- Name of the specialist and his/her specialty
- Specialist’s phone number, address and fax number
- A brief history about your medical condition