You can choose your healthcare specialist
If your health insurance plan is an HMO, or health maintenance organization, you probably know that your primary care physician coordinates all your health care services. Your doctor keeps track of all your medical records and provides routine care.
But what if you need to see a specialist? For most, but not all, HMO plans you’ll need a referral from your primary care physician before you can see any other health care professional (except in an emergency). If your plan requires a referral and you don’t get one first, your insurance won’t cover the cost of your care.
For example, if you get a skin rash, you wouldn’t go straight to a dermatologist. You would first go to your primary care physician, who‘d examine you. If your primary care physician can’t help you, he or she will give you a referral to a trusted dermatologist in your network who will.
However, a little known fact is that you do NOT have to rely on your PCP’s advice regarding which specific specialist to see for treatment. Sometimes, but not always, primary care physicians exclusively refer patients within their own healthcare network, as they are often strongly encouraged to do. In the case that your HMO requires a physician referral, take some time to do your own research, and make sure you feel comfortable with your vein specialist’s reputation, credentials, staff and location, as you will visit the office several times from time of evaluation to final post-treatment check-up.
Good online sources for gathering vein treatment information/area listings for specialists include:
Depending on your insurance plan, upon choosing your specialist, either your primary care physician will let you know when your referral is approved, or the insurance provider will send you a letter in the mail.
Once you get your referral, your specialist can order any medically necessary treatment for you until the referral expires. If your specialist recommends that you see another specialist, you’ll need to coordinate a new referral with your primary care physician for that care.
Please call The Kimmel Institute located in Boca Raton, with any questions regarding our participation with your specific insurance provider. 561-477-0210.