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Health Advantage Referral Reminder
Primary Care Physicians Participating With Health Advantage
For referrals to participating in-network specialist
providers, complete the
"script" (29 KB PDF)
referral sheet.
Referrals to non-participating specialist providers
require prior notification and review for benefits to be authorized. Please use
the
Out-of-Network Referral Request FAX Sheet (120 KB PDF).
Referrals for Open Access members require the
Open Access Out-of-Network Referral Request FAX Sheet (120 KB PDF).
Retroactive referrals are discouraged and may not be eligible for benefits.
Specialist Providers Participating With Health Advantage
Remember, for your services to be considered as in-network benefits, you must place
the referral number marked on the "script" referral sheet in field 23
of the HCFA-1500 every time. If the referral number is not on your claim, then the
service will either be denied or paid as an out-of-network benefit if the patient
has Point-of-Service (POS) benefits.
Retroactive referrals are discouraged and may not be eligible for benefits.
If you have any questions, call your Regional
Office or Health Advantage Customer Service toll free at 1-800-843-1329.
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