Referral Process

Many of the managed care health insurance plans require a referral be obtained before visiting a specialist such as an Urologist. Other insurance plans require no referrals. Each insurance plan is different. It is your responsibility to be knowledgeable about your health insurance including whether a referral is needed each time you visit our specialist.

If your insurance company requires a referral to see a specialist, then it is your responsibility to obtain referrals when:

1. It is your first visit to our office
2. If your insurance company has changed or if your insurance plan has changed (such as Cigna to Cigna HMO).
3. If you change your primary care doctor or have never seen your primary care doctor.
4. If you have not been seen in our office in over a year.
5. If you are being seen for a new diagnosis or new problem.

If you have an insurance plan that requires a referral, it would be beneficial to request a referral as soon as you schedule your appointment with our office. Most primary care doctors require at least 48 hours to process a referral! If you do not have a referral when you come in for your appointment, we will need to reschedule your appointment or your will be asked to sign a waiver and you must pay for your visit in full.

We have an Authorization Specialist in the Business Office that is responsible for obtaining referrals for you as an established patient and will make sure you have a referral unless denied by your primary physician.

We are happy to assist you in any way we can, but we cannot accept responsibility for knowing all of the details of your insurance coverage. Please, contact the customer relations department of your insurance company. They are much more knowledgeable and able to answer your questions better than our staff.

North Carolina Urological Associates currently participates with the following insurance companies. Insurance companies that are in bold letters require an authorization (referral) for your visit to our office. This authorization needs to be sent to our office before the day of your appointment by your primary care physician. Remember, you are responsible for any deductible, co-insurance or other balance not covered by your insurance company

• Aetna
• Aetna HMO
• Beech Street
• Blue Cross and Blue Shield of NC
• Cigna Healthcare
• Cigna Healthcare HMO
• First Health
• Health Care Savings
• Mamsi Life & Health
• Medcost
• Medicare
• Medicaid (not accepting any more new patients)
• Private Health Care Savings (PHCS)
• Travelers Railroad Medicare
• Tricare (Champus)
• Tricare Prime
• United HealthCare of NC