CAPE COD PEDIATRICS
 
CAPE COD PEDIATRICS

REFERRALS

Many insurance plans, especially HMOs, require you to receive approval from your pediatrician (PCP) before you take your child to a specialist. Verify with your insurance company whether you need a referral for the type of visit/service you are seeking.



If you do require a referral, please following these steps:

  • If you have not obtained medical approval for your referral from your PCP, please contact our office through the Patient Online Portal or telephone our office and speak with our nursing staff who will direct your request to your PCP.

  • Make an appointment with the specialist. Be sure to ask them whether they participate in your insurance plan otherwise you may be subject to "out of network" costs. In addition, please obtain the following information: Telephone, Fax, and NPI numbers.

  • Even if our nursing staff is aware of your upcoming specialist visit, they will not notify our referral coordinator. It is your responsibility to contact our referral coordinator and provide her with all appointment information. You can do that by: Notifying your PCP thru our Patient Online Portal or call our referral coordinator at (508) 477-5306 Ext 11.

  • Please allow 5 to 7 business days to process your referrals.

  • Please keep in mind our office can process a referral, but an insurance company can still deny it. What a company covers under your plan is based on your policy. It is your responsibility to know what coverage your insurance company allows.

  • For those patients who are covered by Health net Federal Services (Tricare) please be aware they will not backdate a referral. If your child requires an urgent referral (within 48 hours) you must speak directly with the referral coordinator. If she is unavailable, please call our office and by entering "0" you will be directed to someone who will help you. It is the parent's responsibility to obtain the approval before bringing your child to an appointment.