Get UCHealth Referral/Pre-Authorization Form 2018-2024

What does a referral do? A referral provides information about you and your condition so that: the person you are being referred to does not have to ask so many questions. they are aware of relevant background information.

A referral is an order from your PCP to see a specialist or receive certain medical services from some providers. Your PCP helps make the decision about whether specialist services are necessary for you. Prior authorization is approval from the health plan before you get a service or fill a prescription.

The healthcare provider is usually responsible for initiating prior authorization by submitting a request form to a patient's insurance provider. As mentioned in the “How does prior authorization work?” section above, this will then often prompt a time-consuming back and forth between the provider and payer.

A medical referral form is most frequently used by primary healthcare providers for referral to any secondary healthcare providers or other allied healthcare practitioners. Examples of primary healthcare providers are general practitioners, nurse practitioners, and nurses working with general practice.

The referral certification and authorization transaction is any of the following: A request from a health care provider to a health plan to obtain an authorization of health care. A request from a health care provider to a health plan to obtain authorization for referring an individual to another health care provider.

A written order from your primary care doctor for you to see a specialist or get certain medical services. In many Health Maintenance Organizations (HMOs), you need to get a referral before you can get medical care from anyone except your primary care doctor.