Specialty-to-specialty referrals will only be allowed in limited circumstances. Primary care physicians (PCPs) should generate all referrals for specialty care in KP Online-Affiliate, and specialists should coordinate with the member’s PCP to have the member referred and all relevant clinical information forwarded.
In certain limited circumstances, specialty-to-specialty referrals may be allowed. They include the following, along with those listed in the specialty referral grid♦ .
Ob-gyn may refer to any specialty for all pregnancy related illnesses
Any specialty can refer to hematology/oncology
Any specialty can refer to self-referral specialties (dermatology, ob-gyn, ophthalmology, optometry, office-based behavioral health)
Pediatric specialties follow the same specialty to specialty referral pattern as adult specialties
If you have questions, please contact Provider Contracting and Network Management at 877-465-0029.
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