When Your Physician Refers You to a Specialist

Your physician may determine your medical condition requires a referral to a specialist. Based on the requirements of your insurance plan, we will complete the necessary paperwork and refer you to the appropriate specialist. Many insurance plans allow us to directly refer patients to a specialist without having to wait for prior approval.

Managed Care Patients

If you are a managed care patient, your primary care physician is responsible for directing and managing all of your health care, including referrals to specialists. When your primary care physician refers you to a specialist, you will receive a written referral authorization. We verify the physician network for managed care patients.

All routine referrals must be reviewed by the Utilization Review Board for medical determination. A decision will be made on each specific request and both you and your primary care physician will be notified of this decision in writing.

You should allow a minimum of three (3) to five (5) working days before you receive the response in the mail. You should call the specified specialist care physician to make an appointment only after you have received written approval from Lakeside Community Healthcare Medical Group.

If the specialist care physician requests any further office visits, testing or surgery, the specialist must request those services in writing from your primary care physician. Your primary care physician will then submit the request to Lakeside Community Healthcare Medical Group.

No follow-up appointments should be made or a surgery scheduled until your primary care physician has been notified of the specialist’s findings. Your primary care physician will then submit a referral request for the additional services, and you will receive another letter in the mail.

All Other Insurance

For all other types of insurance that require a referral, please confirm with the specialist care physician’s office that their services are covered by your insurance plan. Most of the specialists we refer to are affiliated with most major insurance plans.

If you have questions regarding your referral, please contact our Customer Relations Department at 818-707-9603, ext. 6001, OR 888-472-7787, ext. 6001, Monday through Friday, 9:00 a.m. – to 5:00 p.m.