I Am a Specialist. Do My Patients Need a Referral?

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I Am a Specialist. Do My Patients Need a Referral?


Referrals are intended to support appropriate care, not to become a barrier to care. Many of our plans do not require a referral, and we want to help save your staff time by avoiding unnecessary work. Investing two, quick minutes watching this video on this page, Do I Need a Referral?" – A Quick Guide, will save your staff much more time in the long run. It will also get you off to a better start with the new patients coming to your office.

Our referral policy has flexibility. Referrals can be filed up to 30 days after the date of service. This means you can schedule appointments and see our members even if the referral transaction is handled after the visits. 

Referral Policy Reminders

  • SOMOS-managed members do not need referrals for dates of service after Dec. 1, 2020.
  • CMS Extends Referral Waiver for Medicare Advantage MembersWhile most of our Medicare plans normally don’t require a referral, all Medicare Advantage members do not need a referral during the COVID-19 State of Emergency. 
Provider Update