Navigating the insurance process can be difficult when you see a specialist. One of the most confusing challenges surrounds the protocols that managed care companies require for services provided. While many traditional and indemnity insurance plans do require a referral, managed care companies typically ask for pre-certification on top of a referral for a procedure you plan to undergo. Not all insurance companies follow the same procedures. Some provide the patient with a referral for their visit, while others offer the patient a referral number. However, a referral doesn’t necessarily give a patient approval to move forward with a procedure or treatment. Referrals give you the documentation you need to see a specialist for a visit or consultation. Depending on your insurance carrier, you may need to obtain authorization each time you visit Laser & Skin Surgery Center of Pennsylvania.

At our Devon office, most of our procedures require pre-certification. This means you may have to return to our office on a separate day after your consultation with the proper pre-certification documentation. How to obtain this authorization varies from company to company. Some insurance companies require a phone call, but others ask for written documentation that is reviewed by a medical director, specialist, clerk, or panel. This process often takes up to two weeks and may require additional documentation, such as photographs and the expected number of treatments. Although the process can be time-consuming, we have a well-trained and experienced billing team that can help you obtain the necessary authorization and pre-certification. Patients can help accelerate the process by reaching out to their insurance companies and following through on submitted documentation.