I’ve been seeing the same specialist for years. Do I still need a referral?

Posted by:

Yes, PEIP is structured in that you need a referral for any kind of specialist appointment, in order for that appointment to be covered. You’ll need to contact your Primary Care Clinic (PCC) to get a referral to the clinic that you have used in the past, in order that those costs be covered. No referrals are needed for emergency room or urgent care visits. You can also self-ref to OBGYN, Chiropractors, Routine Vision, Mental Health/Chemical Dependency, as long as the doctor is within the carrier’s self-referral network. 

Author: