If you have been referred by your TMCOne 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 for scheduling. If you are unsure or know that you require pre-authorization, our referral team can help with the process.
If your referral requires pre-authorization by your health plan, we will request authorization from your health plan. On average, health plans respond to authorization requests within seven to ten business days and this varies from plan to plan.
A TMCOne staff member will contact you within three to five business days once authorization has been received from your health plan. Our staff will assist you with obtaining an appointment and also gather and send medical records to the specialist, if needed. In the event that an authorization is denied, TMCOne staff will work with your provider on providing additional information to your health plan or by creating an alternative care plan, keeping you involved at all times.
As your medical home, TMCOne 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 provider has all of your medical information. This will help enable your provider to provide you the best medical care.
For questions about the referral process contact TMCOne’s Outcomes Assurance Department at (520) 324-4398 or 324-4055.