Referral FAQ

Frequently Asked Questions about Referrals

What is a referral?

A referral is authorization from the patient’s Primary Care Physician (PCP) for
the patient to see a specialist. A PCP is a Family Doctor, Internist, or Pediatrician.

How do I know if I need a referral?

You only need a referral if your insurance company requires you to have one.
The best way to know for sure is to contact your insurance company. The phone
number is located on your insurance card.
Some insurance cards state on the card whether or not you need a referral. If
you are not sure, contact your insurance company before your appointment.

How do I get a referral?

You need to contact your PCP and tell them that you need a referral for your
visit.

How does my referral get from my PCP to the specialist’s office?

You can have your PCP fax your referral to (804) 934 – 0358, for the main office
or (804) 864‐5409 for Physical Therapy, but the best way to be sure we get your
referral is to pick it up from your PCP office and bring it with you to your
appointment. That way you eliminate the chance of it not being here when you
arrive.

What happens if I don’t have a referral the day of my appointment?

Unfortunately, if your insurance company requires a referral and you do not
have one, they will not pay the claim for your visit and the patient/guarantor
will be responsible for the bill.  Therefore, we cannot see the patient without a
referral, unless they sign a referral waiver.

Do I have to get a referral every time I come see a specialist?

Each referral has an expiration date. If you need to come back to the specialist
after the expiration date has passed and specified number of visits, you need
another referral from your PCP. Also, some referrals have a limited number of
visits allowed. For example, the referral may be good for 1 year but only allows
3 visits; therefore, if you need to see the specialist a 4th visit, you will need
another referral from your PCP.