How do I get a referral to a specialist?
Your primary care doctor will send you to a specialist if you need one. A specialist is a doctor who has had more education in a special area of medicine. If you cannot get the care you need from a participating provider in Partnership's network, your primary care doctor must ask Partnership for approval to send you to an out-of-network provider. Your doctor has to approve a referral and send Partnership the Referral Authorization Form (RAF). Call our Member Services Department at (800) 863-4155 if you have questions about the referral process.
You do not need a referral for the services below:
· Primary care doctor visits
· Urgent or emergency room visits
- Obstetrics/Gynecology (OB/GYN) visits
- Family planning services. This includes family planning counseling and education, many types of birth control methods, including emergency contraception.
- Pregnancy testing and support
- Treating and testing for sexually transmitted infections (STI)
- Abortion
- Tubal ligation
- Vasectomy
Call our Member Services Department or your doctor to get more information on how to get these services. You can also call the Department of Health Services, Office of Family Planning at (800) 942-1054. The Office of Family Planning gives information about family planning services and referrals to family planning clinics. You may receive services from any Medi-Cal provider of your choice, including out-of-network providers, without the need of a referral or prior authorization.
Prenatal care – You do not need a referral from your doctor to receive prenatal care from an OB/GYN.
If you are pregnant, call and speak to one of our case managers about our program for pregnant members at (855) 798-8764.
