Topic Area:  

  • Provider networks and referrals

My primary care doctor was out sick and someone else was covering. Am I in trouble because I didn’t get a referral?

Often, when doctors are out sick, their office staff calls to notify patients and reschedule appointments. Sometimes, instead of rescheduling appointments, a doctor may refer patients to another doctor.

If you plan to see a doctor that is covering for your primary care provider, it is your responsibility to confirm that the covering doctor is in-network before you receive care. Learn more about provider networks.

Failure to confirm that you are seeing an in-network doctor can result in limited or no insurance payment for services and high out-of-pocket expenses. If this happens, you can try to appeal the claim by following the steps outlined by your insurance company.