If your insurance requires a referral, please give us at least 48 hours to process your request.
- Most referrals require an appointment with your primary care provider.
- You need to verify with your insurance company that the specialist visit will be covered.
- Make an appointment with your primary care provider after the specialist evaluation.
The Rationale for our Referral Policy …
A referral is the process of obtaining authorization from your insurer to permit you to see a specialist.
If your insurer refused to authorize a referral, you will be responsible for the payment of services.
Most HMO insurance plans require an office visit with your primary care provider to complete the referral process.
Regardless of your insurance it is in your best interest to see your primary care provider first. We may be able to treat many conditions without needing a specialist. If not, we can initiate an evaluation and compilation of pertinent records which would help your specialist evaluate and treat your condition more efficiently. After seeing a specialist it is important to have the evaluation sent to us as part of your medical record. The completeness of your personal medical record is vital to your health. Your participation in obtaining outside records is essential. You are encouraged to schedule a visit with this office to review the specialist evaluation and ensure your medical record is updated.
Medical Records Release Forms
To request medical records from another doctors office, hospital, or medical facility, download "Authorization to Obtain Information." And bring the completed form with you when you come in for your doctors appointment.
To request records released to another doctors office, hospital, or medical facility from East Hampton Family Medicine, download "Authorization for the release of patient Information."
- Most refills cannot be filled without an appointment.
- Controlled substances are never filled without an appointment.
- New York State law now requires all prescriptions to be sent electronically to your pharmacy.
- If your need for a refill request is urgent, you can be seen as a walk-in patient.
The Rationale for our Refill Policy...
A medication refill entails a review of all your medications, medical conditions, prior visits, recent test results and the timing of your next visit. Side efffects and drug interactions need to be identified and monitored. An office visit is the best environment to do this.
It is important that you establish a clear understanding with your provider of how your medications are to be managed. Prescriptions are written to last until your next appointment. Often tests have been ordered to be completed prior to your appointment, so please plan to do these at least a few days before. Prescriptions are written to last until your next appointment. Often tests have been ordered to be reviewed at your appointment,
so please plan to do these at least a few days before.
For example, chronic conditions such as diabetes, hypertension, heart disease and mental health conditions require quarterly provider visits (every 3 months). If the condition is not well controlled more frequent visits may be needed.
Remember, when you are near the end of your prescription it is a reminder to schedule an appointment!
Your safety is of utmost importance!
- Prior authorization (PA) for medications and radiological tests can sometimes take days or even weeks.
- Be aware that your insurance company may deny a medication or radiological tests at their discretion.
- You may be required to take an alternative medicine if our first choice is denied by your insurance.
- We will not provide prior authorization for tests or medications ordered by another doctor.
The Rationale for our Prior Authorization Policy …
A “prior authorization” is similar to a referral but more time consuming and difficult to obtain. This process is required by most insurers as a means of attempting to control the cost of health care. Providers must supply a significant amount of documentation to the insurer to show that a patient meets their criteria. This activity cannot take priority over the immediate responsibility to care for our patients in the office. We share this frustrating requirement with you so please be as patient as possible; we will work to the best of our ability to obtain the approval as quickly as possible. Even with our best effort coverage may not be approved.