Referrals and Diagnostic Testing
What is a Referral?
A referral for a pediatric patient is a formal recommendation made by a child’s primary care provider for the patient to see a specialist or receive additional services outside the primary care office.
Referrals are often needed for evaluations, treatments, or procedures that require specialized expertise—such as seeing a pediatric cardiologist, neurologist, or behavioral health provider. The referral process may involve coordinating with your insurance plan, sharing relevant medical records, and ensuring the specialist has the necessary background to provide the best care for your child’s specific needs.
Referrals help support comprehensive, coordinated care for your child’s health and development.
How long do referrals take?
Please note that once a referral is made, it may take 24 to 48 business hours for our office to process and send it to the specialist’s office. After the referral has been sent, the specialist will review the information and contact your family directly to schedule an appointment.
If you haven’t heard from the specialist within a few days after that time frame, you’re welcome to call their office to follow up.
What types of Diagnostic Tests may require insurance approval?
Common diagnostic tests that may require prior approval from your insurance company include:
- Imaging studies such as X-rays, MRIs, CT scans, and ultrasounds
- Specialty lab testing not routinely performed in a primary care office
- Allergy testing and evaluation by an allergist
- Developmental or psychological testing (e.g., for autism or learning delays)
- Cardiac testing, including EKGs, echocardiograms, or Holter monitoring
- Sleep studies for concerns like sleep apnea
- Gastrointestinal testing, such as endoscopy or lactose intolerance testing
- Hearing and vision evaluations that go beyond basic screenings
Your child’s provider will determine which tests are necessary. Please contact your insurance company and let us know if an authorization is required.
