Occasionally, you may wish to refer a patient to a specialist or facility that is outside of our network of providers. All out-of-Plan referrals require prior authorization (PA), and we make PA decisions based on the patients medical needs and the availability of services to meet these needs within the provider network. Every case is reviewed on an individual basis.
If you would like to make an out-of-plan referral, please contact the Utilization Management Department at 419-887-2520 or toll free at 800-891-2520. Your office may instead choose to fax out-of-plan referral requests. If you would like to fax an out-of-plan referral request, fill out the out-of-plan referral worksheet and fax it to the Utilization Management Department at 419-887-2028 or toll free at 866-214-2024.