Referrals

Most pediatric concerns can be diagnosed and treated at our office. However, should your child need a consultation from the specialist, our physicians will discuss the proposed referral with you and then initiate the process.

Referral Frequently Asked Questions:

Q: When is a referral required for my child to see a specialist?

A: It is always a good idea to contact our office before taking your child for specialty care.  We can make your doctor aware of your child’s medical condition and give you recommendations so your child receives the best possible care.  If you have a managed care policy, the charges will not be covered without a referral from your primary care physician.  Many specialists also require a letter and chart notes from your PCP prior to scheduling even if your insurance does not require one.

Q: What if I see a specialist and forget to request a referral first?

A: Some insurance policies will allow for retroactive referrals but some will not.  You may be responsible for the charges.  Call our business office as soon as possible after your child is seen.

Q: What should I do if my doctor refers my child to a clinic at Seattle Children’s Hospital?

A: Our office will need to submit an appointment request to the clinic before they will schedule your child.  Please allow 48 hours for this process to be completed before you call to schedule.  If your doctor did not provide you with the direct number to call, you can contact the main hospital operator at 206-987-2000 and they will connect you with the specialty clinic.

Q: What if I am seen at the Children’s After Hours Clinic or an Urgent Care Center?

A: If your insurance policy requires referrals, please contact our office on the next business day.

Q: What if my doctor recommends speech, physical or occupational therapy services for my child?

A: You should first check with your insurance company to see what services are covered by your plan.  Some policies do not cover ‘neurodevelopmental services’, or will only cover them up to a certain age or for a certain type of diagnosis.  If services are covered, you will need to go to a contracted provider and have a prescription from your doctor.  Our office can provide you with a list of resources in your area.

Q: What if my child requires a mental health or behavioral consultation?

A: Mental health and behavioral consults are often handled differently by the insurance companies.  Please refer to the special phone number on the back of your insurance card to access these benefits.  In many cases, this type of referral must be initiated by the parent/guardian as opposed to the doctor’s office.