Connecting you with the care you need.

About the Referrals Department at South Boston Community Health Center

Our Referrals Department is here to guide you through the referral process for any specialty care you may need. We understand that navigating referrals can feel overwhelming, and we’re here to ensure a smooth transition from our primary to specialty care, and all of the insurance complexities in between.

What is a Referral?

A referral is an official recommendation from your primary care provider for you to see a specialist or undergo specific tests, imaging, or consultations. In many cases, your insurance plan will require a referral from us before covering specialist visits or certain procedures. Our team manages the paperwork, coordinates with insurance, and ensures that your referral reaches the right specialist.

How the Referral Process Works

1. Initial Consultation with Your Provider
   During your appointment, you and your SBCHC provider will discuss your health needs together, and your provider will explain why a specialist or test might be recommended and answer any questions.
2. Referral Processing
   After a decision is made to refer you to a specialty facility, our Referral Coordinators will submit the referral order and supporting documentation to your insurance plan for authorization (if required). This process may take a few days, depending on how fast the insurance reviews our request for authorization.
   This is the best time for you to call the desired specialty facility to register yourself in their system (if you haven’t been seen at their facility before).
   Once we have insurance approval (if required), we will send your provider’s referral order, supporting documentation, and insurance authorization to the specialty facility dictated in your referral order.
3. Confirmation & Scheduling
   Once all required documents are sent to the specialty facility, you are ready to schedule.If the facility will allow us to book your visit on your behalf, our team will attempt to book the soonest available appointment and notify you of the appointment details through MyChart, phone, or letter.If the facility will only book directly with you, the patient, we’ll provide you with the contact information necessary to schedule yourself.
4. Follow-up Care
   After you see the specialist, your SBCHC provider will follow up with you to discuss any findings or treatment recommendations. We want to make sure that all aspects of your care are coordinated and that you feel supported.

Frequently Asked Questions

If I need specialty care, where should I start?
Your primary care provider (PCP) can help you with specialty referrals. Send your PCP a message through MyChart to start the discussion. They may want to see you for a visit before referring you elsewhere, and this is because:

• • Your PCP may actually be able to diagnose/treat your health issue without input from a specialist.
  • Your PCP may need to gather additional information regarding your health issue, such as labs or xrays.
  • For insurance purposes, your PCP may need to document that you’ve discussed your health issue at length prior to deciding about a referral.

How long does it take to process a referral?
Referrals typically take 3-5 business days to process, depending on insurance review and how quickly we can connect with the specialty facility. Our team will keep you updated along the way through our MyChart patient portal.

Who should I contact with questions about my referral?
Feel free to reach out to our Referrals Department with any questions or concerns. Our contact information is below.

What if my referral is denied by my insurance?
If insurance denies the referral, we will work with you and your provider to understand your options, including submitting an appeal if appropriate.

Contact Information for the SBCHC Referral Department

• Referrals Department Phone: (617)464-7453
• Fax: (617)464-7690
• Office Hours: Monday - Friday, 8:00 AM - 5:00 PM

Our team is here to help you navigate the referral process every step of the way. Please don’t hesitate to reach out with any questions or concerns.