HNS Policy 

 

When referrals to other health care providers are clinically indicated, including but not limited to, specialists, diagnostic testing, hospital-based services, or to vendors for DME, HNS providers must make every effort to refer to healthcare professionals who are participating and/or approved by the member's healthcare plan. If you are unsure if the referral is to an approved provider/vendor, prior to initiating the referral you must check with the contracted health care plan directly to ensure that the referral is appropriate.

 

Healthcare records must include written evidence of all referrals from other health care providers as well as referrals to other health care providers. The health care record shall include copies of all notes/records/communications to and from the provider to whom the patient was referred to ensure appropriate coordination of care.