Referrals and Pre-Authorization
If you have an HMO or a Multi-Tiered HMO health insurance plan, it may be necessary for you to obtain a referral before making an appointment with a Menlo Clinic specialist.
If your Primary Care Physician is not at Menlo Medical Clinic, you must provide proof of referral upon scheduling your appointment.
Many insurance companies including HMO (managed care) and PPO require a primary care physician to initiate referral and authorization processes for all services rendered outside of our clinic.
Various specialty services may require additional review by the health insurance plans. Some examples of services that require review or pre-authorization are sleep studies, physical therapy, procedures, surgeries, medical equipment and second opinions.
Our goal is to provide services in a timely manner. However, once the request is transferred to the insurance company and additional review is required, we must await their response.