New CHA Policies for Referrals

06/22/2017

Someday, most of us will have a health problem we think requires specialty care or testing. As a patient, where do you start? What steps should you take and what rules you do need to follow?

At CHA, we recently updated our policies for managing specialty referrals and prescription renewals. Here is what you need to know:

  1. If you have a health need you think requires specialty care or testing, please start with your primary care team. We want to evaluate your needs and help guide your care. You may be asked to come in first for a primary care visit. This is very important if you are a new patient or haven’t seen us recently.
  2. Our policy is to refer within CHA whenever possible. CHA has excellent specialists and testing services. This includes board-certified doctors who trained at some of the nation’s best hospitals, and services like CT, MRI, Mammography and Cardio-Pulmonary testing. Our specialists will work with you and your primary care team to meet your health needs.
  3. CHA does not approve same day or retroactive (backdated) referrals. This is important because many insurance plans (like HMOs) require that you get a referral from your primary care team first. Without this, you may have to pay all the costs of the specialty visit or test, not just the co-payment or deductible.

    Please remember to get a referral from your primary care team before seeking specialty care. And please give us time to process your request.
  4. If you need to renew a prescription, please contact us by phone or MyCHArt. Your doctor may want to see you first, based on your medical history and symptoms.

We are confident that these changes will give you, and all other CHA patients, higher quality and more coordinated care. But if you have any questions or concerns, please let us know. You can call your primary care center or send us an email.

Thank you for choosing CHA for your care. We wish you the very best health.

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Cambridge Health Alliance

Contributed By: Cambridge Health Alliance

Cambridge Health Alliance is an academic community health care system committed to serving all members of our communities. We have expertise in primary care, mental health and substance abuse, and caring for diverse and complex populations. CHA patients receive high quality care in convenient neighborhood locations, and have seamless access to advanced care through CHA’s affiliation with Beth Israel Deaconess Medical Center. With over 140,000 patients in Cambridge, Somerville Everett and Boston’s Metro North, CHA is working hard to offer the integrated services its communities need now, and in the future.