The Pediatric Group, PC - Northern Virginia Pediatricians

1. Check with your insurance to find out if you need a referral. If you are unsure about this, you can call the member services number on your insurance card to find this out.
2. If a referral is required, please call and make an appointment with the specialist at least 10 business day from the date you call to make the appointment. We will need 5 to 7 business days to process the referral.
3. Next call our office immediately after making the appointment to requrest a referral. Our triage nurses will need the following information to process the referral: 1) Name of Specialist your child will be seeing, 2) Specialist Phone number, 3) Specialist Fax Number, 4) Date of the appointment, 5) Reason for the appointment, & 6) if the specialist wants the referral to be faxed or you need to pick up the referral .

Many insurance companies require you have a written referral or prior authorization when seeing a specialist or undergoing certain diagnostic procedures or tests. It is essential that you know the details of your individual insurance plan. If your insurance requires a referral, please call our staff. We will need the date and time of your child’s appointment, and the name, phone and fax number of the specialist you are seeing. We require five to seven business days to complete a referral, and seven to ten business days for prior authorizations. Once your referral has been completed, you must pick up the referral at the office. Please remember referrals cannot be completed after the actual appointment. Please do not see a specialist or have a diagnostic procedure done and then call us for the referral. Your insurance companies require this protocol, and they will not allow us to back date or complete a referral after a visit has been performed.