Referrals and Precertifications

Referrals

If your medical condition requires the attention of a specialist, your family doctor (primary care provider, or PCP) may recommend that you see a specialist within the Dartmouth-Hitchcock Health system. This is known as a referral.

Things to remember about a referral

  • Be certain the referral is for a service covered by your health insurance plan. 
  • The referral should be to a provider within your health insurance plan’s network. 
  • Check for limitations on the referral, for example, the number of visits allowed or expiration date.
  • When your PCP gives the referral, information about your related conditions, tests, or health risks will be shared with the specialist. Your PCP also monitors your care if you become hospitalized.
  • Remember, contact your PCP about a referral prior to your specialty appointment.

Precertification or prior authorization

Information about these requirements is usually listed on the back of your health plan insurance card. Please refer to your card or your benefits handbook, or contact the customer service section of your health insurance plan to inquire about your responsibility to complete these requirements.