Precertification & Referrals

Precertification questions?

You can call the Church Street office at (770) 422-8505 during office hours to speak with the appropriate person. Please have available your insurance information, including the name of your primary care physician (if applicable), and the specific nature of your question.

Some office procedures and most surgeries require precertification from your insurance company. If you are scheduled for surgery to be done by one of our physicians, we will precertify the procedure with your insurance company. This can be confirmed by calling the Church Street office 3 to 5 business days before your surgery or you can check on this at the time of your pre-operative appointment.

For office procedures we will do our best to ensure that a precertification is obtained from your insurance provider. However, due to the tremendous variations between insurance plans of what requires precertification, it is your responsibility to ensure precertification has been obtained, if needed.

Specialist or Referral Questions

Do you need a referral to a specialist, or does your insurance require a referral? To contact us with referral or specialist questions you can call the Church Street office at (770) 422-8505 during office hours to speak with the appropriate person. Please have available your insurance information, including the name of your primary care physician (if applicable), and the specific nature of your question.

Most insurance companies do not require referrals for you to see an OB/GYN. However, there are a few companies that are self-funded that may require a referral. If you have any questions regarding this, please contact your insurance company.

This is when it is most important for you to know the specific type of healthcare plan you participate in (HMO, etc.) and whether or not your plan is part of a specific network. This will make the referral process much less time consuming for both you and our office staff.

As OB/GYN’s we are usually able to make referrals only for the care and evaluation of problems that would be part of routine obstetric or gynecologic care. For general medical problems or evaluation, referrals are usually handled by your primary care physician (PCP). This is also an important time to know whether you have out of network benefits.

If one of our providers refers you to another physician or for a diagnostic test, we will do our best to try to make sure you have the appropriate referral number before your appointment. You may be asked, however, to make the appointment with a physician of a particular specialty (such as urology) who is within your network and then call us back with the name of the physician and your appointment date and time. We will then obtain the referral for you. Please be aware that this can take 5 to 10 business days.

To make your visit to the specialist hastle-free, it is always recommended that you to check with your insurance company to see if a referral is needed for your specific situation and to make sure that number is available to the appropriate provider BEFORE you arrive for your appointment.