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Making a Referral
The following services do not require a referral from a Primary Care Physician
- Gynecological and obstetrical services rendered by an in-network provider
- Emergency care services rendered within 72 hours of an injury or sickness.
- Behavioral health services (which must, however, be pre-certified)
- Chiroselect services
Members are advised to notify their Primary Care Physician following a visit to an urgent care or an emergency room.
The Referral Process
If a referral is needed, as an OSU Health Plan provider you must refer the member patient to another provider within the network. Any standard or referral consult form or other means of communication between you as the referring physician and the chosen consulting physician is acceptable. It is not necessary to send a copy of the referral to the OSU Health Plan.
If you need to verify whether a provider is participating in the network, call the OSU Health Plan at (614) 292-4700 or (800) 678-6269.
Any provider interested in referring a patient to, or talking to, a physician at The Ohio State University Hospitals or Arthur G. James Cancer Hospital regarding a medical concern may call the OSU ConsultLine at (800) 824-8236.
Out-of-Network Referrals
Any referral to an out-of-network provider must be pre-authorized by the OSU Health Plan. To obtain prior authorization, call OSU Health Plan at (614) 292-4700 or (800) 678-6269.
Behavioral Health Referrals
While it is not necessary for members to obtain a referral for behavioral health services, these services must be pre-certified within one day following the date of service. Members are encouraged to inform their Primary Care Physician of any treatment that may affect them physically.