Helps members understand when a specialty referral is needed, how to request one from their Primary Care
Provider (PCP), and how to avoid delays caused by missing documents or incomplete information. Support focuses
on navigating health plan rules and completing follow‑up steps.
Support covers
- Understanding when a specialty referral is required
- Requesting referrals from the PCP
- Checking Medi‑Cal or Medicare referral rules
- Submitting required documents
- Following up on pending referrals
- Scheduling specialty appointments once approved
- Understanding referral notices and plan decisions