What is the difference in provider referral and insurance referral?
The difference between an insurance referral and a provider referral.
If a provider refers a patient to a specialist, does the patient still need an insurance referral?
What if the insurance company does not authorize the referral?
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Answer by Micki 48
Find out if your insurance requires authorization from them before you can see a specialist. Many insurance plans don't. If yours does, then you will need approval from them before you see the specialist, even if your provider refers you to one. If the insurance company doesn't authorize a referral, then I believe most insurance plans have a procedure for you to appeal that decision.
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