Coordinated Care

While there are many acute and chronic illnesses and conditions that we can handle in our office, children sometimes need the expertise of a specialist in a given area. We are fortunate to have many pediatric specialists in this area that we work with directly to coordinate the best possible care for your child. We only refer to specialists we know and trust with the care of our patients. See our list of approved specialists here.

What is a referral?

There are two parts of a referral. First, we recommend or agree with a patient or parent that our patient should see a specialist. We usually recommend a specific doctor or practice, or have a list to choose from.

Second, a referral may also involve obtaining authorization to see a specialist from either the specialist, or the patient’s insurance company, or both. Many insurance companies no longer require a formal referral authorization.

Managing referrals

As a medical home for children, we manage all aspects of referrals for our patients. Usually, we are the ones recommending a visit to a specialist, although sometimes that recommendation comes from an emergency room visit or another specialist. We provide whatever information is necessary to specialists and insurance companies to authorize the referral, and we carefully follow-up on the visit and the specialist’s findings and recommendations.

We only refer to specialists who we feel provide the best care for children and who communicate back with us so we can manage and coordinate all of our patient’s care and his or her overall health and well-being.

Referral requirements

In order to provide a referral, we must be familiar with the medical condition for which the referral is needed. Usually, this means having been seen in our office for the condition. Sometimes, such as in the case of a broken bone or other injury, we can make the referral based on the emergency room, urgent care, or other specialist’s report.

Children also must usually be up-to-date with well-child visits in order for us to make or renew referrals, so that we can be familiar with the child’s current medical history and status of the condition needing a referral.

Referral Instructions

1. You will be given information on the specialists we recommend.
2. You call the specialist to arrange an appointment, unless it is a specialist that require that we contact them first with your child’s information. If so, then they will contact you to schedule an appointment.
3. After you make your appointment, contact us through the portal with the information on the specific practice and doctor or therapist your child will be seeing.
4. We will send them information on your child’s condition and medical history.
5. If your insurance plan requires a referral, we will submit the referral to your insurance plan (we cannot do this until you have made the appointment because the insurance plan has to know which specific doctor you are seeing at any given practice).
6. After your visit with the specialist, we usually receive a written report with recommendations. As your child’s medical home, it is important that we have records from your visits with specialists. We will work together with you to determine the best course of action and to coordinate the care of your child along with the specialist or specialists.