Standing referrals
A standing referral allows a member to see a specialist without needing new referrals for each visit. Members may request a standing referral for a chronic condition requiring specialized care. The member’s primary care physician will decide when the request meets the guidelines outlined below.
1. A standing referral must be authorized for the following conditions:
- Chronic health condition
- Life-threatening mental or physical condition
- Pregnancy beyond the first trimester
- Degenerative disease or disability
- Radiation treatment
- Chemotherapy
- Allergy injections
- Defibrillator checks
- Pacemaker checks
- Dialysis/end-stage renal disease
- Other serious conditions that require treatment by a specialist
2. The number of visits authorized must be sufficient to cover the duration of the condition. A standing referral is limited to 12 months but it can be renewed as needed. Renewals of standing referrals must be done annually.
3. Members who change clinics will need to check their standing referral with their new primary care physician. Changing clinics may change the specialist to whom the member’s primary care physician makes referrals.
4. Members may request that they receive certain primary care services from their specialist. The specialist, in agreement with the member and the member’s primary care physician, may choose to provide these services, including authorizing tests and services and making secondary referrals. Secondary referrals are referrals to other specialists. These primary care services must be related to the specific condition or conditions for which the standing referral is made.
Note: Standing referrals are not always needed, depending on the network your plan uses. If you have an open access network, you do not need referrals. HealthPartners primary clinic networks are made up of many care networks (groups of related clinics and doctors). Each care network decides how their patients can get access to care. Some care networks do not require referrals at all. Others require referrals to some or all specialists.