Referral Requirement
SCOTT & WHITE HEALTH PLAN ANNOUNCEMENT
ELIMINATION OF NETWORK SPECIALTY REFERRAL REQUIREMENT
SWHP is pleased to announce that a referral will no longer be required to insure payment to Network Specialists.
If a physician wishes to refer to an Out Of Network Specialist a Prior Authorization from SWHP is needed. Please go to swhp.org Provider tab to access our Prior-Authorization Form.
Members of SWHP are allowed to self refer to a Network Specialist without the need for a PCP referral. Providers may continue to use any referral processes they currently have in place, however SWHP will no longer be requiring this referral to make payment.
For services requiring Prior-Authorization, please go to swhp.org to the Provider tab to access our Prior-Authorization Form.
We are making this change to facilitate patient's access to care and to decrease the administrative work and demands on your office. Please let us know of other ways we can facilitate these important goals and appreciate your support in communicating this information to your staff.
Regards:
Dr. Marylou Buyse, M.D., M.S.
Chief Medical Director
Maria Lima-Leite, MPH/HA
Vice President, Medical Delivery Development