Do I need a referral to visit?
Self-Referral (No Referral Needed)
Many patients do not need a referral to visit a wound care center — especially if:
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They have Medicare or commercial insurance that allows specialist visits directly.
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The wound is visible, chronic, or worsening, and the patient seeks evaluation directly.
In these cases, patients can call and schedule their own appointment without seeing their primary care provider first.
Referral Required (When It’s Needed)
Referral from your PCP is required under many HMO, Medicaid, and managed care plans*. In these cases, the patient’s PCP or specialist must submit a referral form and possibly a medical necessity note for insurance approval.
If you have ongoing wound care needs, state law allows us to help you get a standing referral through your PCP so you don’t need to get repeated referrals each visit.
Why Referrals Can Help
Even when not required, referrals can:
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Ensure your wound care team receives complete medical history and medication lists.
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Help coordinate care with the patient’s existing providers.
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Improve continuity and follow-up for chronic conditions like diabetes or vascular disease.
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Help avoid billing issues and unnecessary out-of-pocket costs.
If you’re unsure whether you need a referral, we’ll verify your insurance for you and help guide the process so there’s no surprise. Insurance verification is done at intake; we will assist to ensure any required referral or authorization is properly submitted.
*A managed care plan connects you with a network of approved doctors. Your primary doctor helps coordinate your care and gives referrals for specialists when needed.
Contact
If you have any questions, please feel free to reach out to us.
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