At North Olympic Healthcare Network, we get a lot of questions from patients about referrals. We hope you’ll take a moment to review the information below to gain a better understanding of the process involved in getting you the care you need.
Referral to a Specialist
Sometimes your primary practitioner, the NOHN provider responsible for your overall health care, may want you to see a specialist. A specialist is a type of doctor who is an expert in a particular medical field such as cardiology or surgery. Insurance companies usually require that you first be evaluated by your primary practitioner for any problem which is referred to a specialist.
If your primary practitioner wants you to see a specialist, they will generate a referral within our electronic health record (EHR) system that includes:
- The specialist or practice to whom you’re being referred
- The reason for the referral
- The type of referral – consultation, single visit, etc.
- The urgency of the referral
- Relevant clinical information as appropriate
Our referral staff will work to obtain pre-authorization from your insurance company. We make every effort to process your referral in a timely manner. Because the process is complex, it can be subject to delays. Some factors are out of our control, including insurance authorization and specialist scheduling.
Please note the following estimated timeframes:
- Routine Referrals – 2 business days
- Urgent Referrals – 1 business day
- Emergent Referrals – Same day when received during business hours
- Insurance Authorization – 4 to 6 business days
- Specialist Scheduling – 10 to 14 business days
If you haven’t received any communication regarding your referral within 10 business days, please contact our Referral Coordinator at (360) 452-7891 x 2846 or send a message via MyChart.
A Word About Insurance
Your insurance company may require pre-authorization for your visit with the specialist, and some plans will not pay for your visit if you have not received prior authorization. Further, insurance coverage for a specialist’s services depends on several factors, including whether the specialist is contracted as an in-network provider with your insurance company.
To avoid authorization delays and surprise bills, please consult your insurance plan or check with your insurance company for their requirements and coverage.