You have been referred by your TMC One care provider to a specialist or for a diagnostic test. We want to help guide you through this process by providing you information and coordinating with your insurance company to ensure you receive your care in a timely manner.
Depending on your health insurance coverage, you may need pre-authorization prior to proceeding. If you know that you do not require pre-authorization, you may contact the specialist or diagnostic testing facility directly. If you are unsure or know that you require pre-authorization, our team can help with the process.
A TMC One staff member will contact you within two business days. If you do require pre-authorization, we will proceed with the request and you can expect a response from your provider within seven business days of the request.
Once the pre-authorization is given, our staff will assist you with obtaining an appointment and also help in preparation by gathering and sending medical records to the specialist, if needed. In the event that an authorization is denied, TMC One staff will work with your care provider on providing additional information to your insurance carrier or by creating an alternative care plan, keeping you involved at all times.
As your medical home, TMC One maintains your test results and your medical record. Make sure to request that your specialist or diagnostic test provider send copies to our office so that your primary care doctor has all your medical information. This will help enable your doctor to provide you the best medical care.
For questions about the referral process, please contact the TMC One Outcome Assurance Department at 324-4055. For any other questions, you may call our Administration office at 324-4774.