Ob gyn referral 2025

See details

4.8 out of 5

156 votes

The document is a referral form for Gateway Health Plan, specifically for OB/GYN services. It outlines the necessary provider and patient information required for issuing referrals, emphasizes that each referral requires a new form, and specifies that referrals are valid for 90 days. It also notes that members must be referred to specialists through their primary care practitioner, with exceptions for perinatologists, and highlights the importance of using designated laboratories for lab testing.

Here's how it works

01. Edit your gateway referral form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send ob referral via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out ob gyn referral with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the ob gyn referral in the editor.
Begin by filling out the PROVIDER INFORMATION section. Enter the OB/GYN Provider Name and Provider Number, ensuring accuracy for claims payment.
Next, move to the PATIENT INFORMATION section. Fill in the Patient Name, Gateway Member ID#, Diagnosis/Complaint, and Provider Phone #. This information is crucial for processing referrals.
In the FACILITY INFORMATION section, specify the Facility Name and Facility Provider ID#. Ensure that all details are correct as this will affect service validation.
Review the Referred Services options and check any applicable boxes. Specify lab testing details if necessary.
Finally, sign and date the form in the OB/GYN Signature and Referral Date fields. Remember, an unsigned form is invalid.

Start using our platform today to streamline your ob gyn referral process for free!

See more ob gyn referral versions

We've got more versions of the ob gyn referral form. Select the right ob gyn referral version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (156 Votes)
2013	4.2 Satisfied (39 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can urgent care refer you to an OB-GYN?

Referral to Specialists OB/GYN Care: If your condition requires specialized attention, urgent care can refer you to an OB/GYN. This ensures you receive the comprehensive care you need for more complex issues.

Why do I need a referral to see an OB/GYN?

There are many different reasons for seeing an OB/GYN. Many people wonder, how do you go about seeing one? The answer is simple: You dont need a referral to see an OB/GYN, you can find one that is accepting new patients and call to make an appointment (always check with your insurance first if you have it!)

How do I ask for a referral for a gynecologist?

To obtain a referral for an OB-GYN, contact your primary care provider or health insurance company. They can guide you through the referral process based on your insurance plan. Some plans require referrals for specialist visits, while others allow direct appointments.

What happens at a gynecology referral?

During your appointment, the doctor or nurse will talk to you about your symptoms and which tests and investigations they would like to do. The tests and investigations you may need will depend on your symptoms. You may have several tests at one appointment so that you dont have to come in more than once.