As outlined in the Hospital Manual for Participating Hospitals, Ancillary 
Facilities, and Ancillary Providers and the Provider Manual for 
Participating Professional Providers, when referring an Independence member 
for a surgical procedure or hospital admission, the primary care physician 
needs to issue only one referral* to the specialist or 
attending/admitting physician.
Please note the following:
 
- The referral will cover all facility-based (i.e., hospital, ambulatory 
surgical center) services provided by the specialist or attending/admitting 
physician for the treatment of the member?s condition.
- The referral is valid for 90 days from the date it was issued.
- The admitting physician should obtain any required preapproval.
- Any pre-admission testing and hospital-based physician services (e.g., 
anesthesia) will be included under the hospital or surgical preapproval.
Please ensure the referral, when required, is on file to the specialist or 
attending/admitting physician prior to rendering the surgical/outpatient 
procedure or other outpatient service or your facility-based portion of the 
claim may be denied for lack of referral. 
Certain products (e.g., HMO, POS, PPO) have specialized referral and 
preapproval requirements and/or benefits exemptions. It is important for 
providers to utilize the most current precertification requirement lists on our 
website. Failure to obtain 
precertification for any of the services that require precertification may 
result in a reduction in payment or nonpayment for services provided.
*As of January 1, 2018, referrals are no longer required 
for Medicare Advantage HMO/POS members.