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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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Most health plans do not require patients to receive a referral from their PCP to acquire specialist care. This makes it more critical for a solid physician-patient connection where the PCP can direct patients towards the very best therapy and specialty care, when required.
Request an open referral from your GP This is known as an 'open referral' which you may request from your GP, and it means that your referral can be presented to any specialist you choose, as long as they're in the referred speciality field.
EPO vs PPO eligible expenses A PPO offers more flexibility with limited coverage or reimbursement for out-of-network providers. An EPO is more restrictive, with less coverage or reimbursement for out-of-network providers. For budget-friendly members, the cost of an EPO is typically lower than a PPO.
This program features a full range of in-network benefits with low out-of-pocket costs, no claim forms, and access to quality health care for you and your family. With Empire's Blue Access Gated EPO, every family member can choose his or her own Primary Care Physician (PCP).
With Empire's EPO (Exclusive Provider Organization) plan, you have access to an extensive network of doctors and hospitals across the country. So chances are your doctor is in our network. You don't need to pick a Primary Care Physician (PCP), and you don't need a referral to see a specialist.
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People also ask

A referral, in the most basic sense, is a written order from your primary care doctor to see a specialist for a specific medical service. Referrals are required by most health insurance companies to ensure that patients are seeing the correct providers for the correct problems.
A client referral form can be used by businesses to encourage previous and returning clients to refer their services to new and potential clients. This form can be used to gather relevant information such as the contact details of the referral and so on.
A referral is a written request from one health professional to another health professional or health service, asking them to diagnose or treat you for a particular condition.
It is unlawful to backdate referrals, doing so would breach the Commonwealth Health Insurance Act. We can only provide repeat referrals to medical specialists that you have seen previously. Your GP may not be able to provide a repeat referral if they have not seen you recently.
A referral from a general practitioner (GP) to a specialist lasts 12 months, unless noted otherwise. The referral starts from the date the specialist first meets the patient, not the date issued.

empire bcbs managed care referral form