Referral Process

Helping you get the care you need

If you have been referred by your TMCOne provider to a specialist or for a diagnostic test, we can help provide you necessary information and coordinate with your insurance company to ensure you receive your care in a timely manner.

Depending on your health insurance coverage, you may need pre-authorization prior to proceeding. If you know that you do not require pre-authorization, you may contact the specialist or diagnostic testing facility directly for scheduling.

If your referral requires pre-authorization by your health plan, we will request authorization from your health plan. On average, health plans respond to authorization requests within seven to 10 business days, although this varies from plan to plan.

Once authorized (if necessary), our staff will send the appropriate medical records to the specialist along with the referral. You will then be contacted by the specialist’s office to schedule. In the event that an authorization is denied TMCOne staff will provide additional information to your health plan to appeal the denial, suggest a covered specialist or have your provider create an alternative care plan. You will be involved at all times.

As your medical home, TMCOne maintains your test results and your medical record. Make sure to request that your specialist or diagnostic test provider send copies to our office so that your primary care provider has all of your medical information. This will help enable your provider to provide you the best medical care.

For questions about the referral process, contact your provider's office.