Patient Education & Resources

REFERRAL

An important aspect of having a managed care health plan or HMO Insurance is having your primary care physician assess your health care needs. This step helps your provider to clarify your medical record to properly diagnose the problem and to give you a better chance of being referred to the most appropriate specialty physician.

**If you seek the services of a specialist without a prior authorized referral, you may be held financially responsible for the entire specialty service.**

Our Referral Specialists can assist with the HMO Referral Process. You can contact the office and request a referral authorization prior to any specialty service being rendered. If your insurance requires we process a referral, we must document the required criteria before processing the referral. If the criteria is met, the referral authorization must be requested and received prior to your specialist visit. It is the patient’s responsibility to become familiar with their insurance policy and its requirements for obtaining referrals.

So that we may accommodate your requests and needs in a professionally efficient and timely matter we ask that you familiarize yourself with Mount Vernon Internal Medicine’s Referral Policy below. If you have any questions regarding the policy, please ask for clarification.

Mount Vernon Internal Medicine Referral Policy

- A minimum of 48 hours is needed for this office to process non-emergency referral requests.
- Emergency referrals will be handled as quickly as possible.
- It is the patient’s responsibility to make sure that they have complied with the referral policy guidelines of our office and have met the requirements mandated by their health plan. The patient must have an approved and completed referral form or authorization number in hand PRIOR to examination by a specialist or testing performed.
- Retroactive Referrals WILL NOT be issued. If you are seen by a specialist or facility without the proper referral, your insurance carrier will most likely deny coverage and you will be responsible for charges incurred. If you receive treatment in a hospital emergency room or urgent care facility during a weekend, holiday or after hours, you must report this to our office on the first business day following treatment, so we can provide proper authorization to that facility.
- If a specialist refers you to another physician or facility you must contact our office for that referral.

How to Obtain a Referral:

  1. Select a specialist - contact your insurance carrier for an In-Network provider listing or ask our staff for a list of recommended specialists in the area to compare.
  2. Call the specialist’s office and make an appointment (be sure you give yourself at least 48 hours before the appointment so you can obtain a referral) – verify that the specialist is PARTICIPATING with your insurance plan.
  3. IMMEDIATELY call our office at (703) 780-2800 and select the option for the referrals. If it goes to voicemail please speaking slowly and clearly, and leave the following information:
    - Your full name (spelling out your last name) and date of birth.
    - A phone number where you can be reached or where a message can be left.
    - Name and phone number of the specialist you will be seeing (please give the address if you have it available).
    - The reason for your visit to the specialist, the date and time of your appointment.
    - Please state whether you will be picking up the referral from the front desk or if you prefer it mailed to your home.
     

Specialist Follow-Up Referral Requests

In order to ensure the processing for a referral plan authorization, we request that you contact the office at minimum of 5-10 business days ahead of any scheduled appointments. If the Referrals Specialist does not have enough notice, they will not be able to process same-day referrals requests. Therefore, you may be required to reschedule your specialty care appointment or be held financially responsible.

 

FAQ'S

1. Do I need to schedule an appointment?

Yes – all patients are seen by appointments. In case of an emergency, you will be seen with 24 hours by the next available provider.

2. What do I need to do as a new patient?

Please arrive 15 minutes prior to your first appointment to fill out forms and so we can verify your insurance.

3. What do I need to do before I see the doctor?

All patients are seen by appointments. Upon arrival, please be sure to sign in at the front desk. Inform the receptionist of any changes in address, phone number or insurance information. Patients are called by order of appointment time as long as patients are present.

4. What do I need to do when I am done with the doctor?

Check with the front desk receptionist to :

  • Schedule your follow-up appointment
  • Schedule testing if necessary
  • Pay your co-pay or deductible if you did not at check in.

5. How do you notify the patient with the test results?

Normally, the doctor will discuss the results of the tests during the follow up visit.

6. How long does it take for the doctor to receive the test result back?

We normally receive the blood test results in 24 to 48 hours. Xrays and other testing results are sent out to be read. We receive them back in 7 to 10 business days. 

7. Am I informed or reminded when my appointment is?

Yes, our office will send you a reminder baised on your preferred contact method 48 hours in advance of your appointment.

9. What do I do if I can't make it to my appointment?

Please call and cancel your appointment within 24 hours. Otherwise, you will be charged a  fee.

 

Visit the NCQA website for more information on a patient centered medical home and what it means for you. 

 

SPECIFIC HEALTH INFORMATION

SELF-MANAGEMENT TOOLS


PATIENT RESOURCES

Authorized Durable DNR Form (VA Department of Health)

 

INSURANCE COVERAGE

Straightforward, honest, health insurance quotes. Just for you.
Get a free insurance quote.

 

DEA Controlled Substance Disposal Site

If you would like to return unused narcotics, the Drug Enforcement Administration has created a website to find nearby controlled disposal locatons.  After entering your zipcode, the site will list all locations within a 50 mile radius.  https://apps.deadiversion.usdoj.gov/pubdispsearch/spring/main?execution=e1s1