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Referrals and Prior Authorizations

Referrals

A PPO gives you the flexibility to go to most providers without a referral. However, some specialists—and specialty treatment centers (like nephrology or infusion)—may require a referral from your primary care doctor or prior authorization from Anthem Blue Cross before you can make an appointment.

Be prepared: When scheduling an appointment, ask the provider’s office staff if a referral and/or other authorizing information is required prior to your initial visit.

Prior Authorization

Certain services, such as a planned surgery with an overnight hospital stay, require prior authorization from Anthem.

Find a list of services that require prior authorization in the UC Care Benefit Booklet.

If you have a procedure scheduled or a condition that will require treatment, you may need prior authorization from Anthem. Contact Anthem Health Guide, toll-free, at (844) 437-0486 for assistance.