Referencias y Autorizaciones
El Alliance’s Referral Consultation Request Process Policy covers the requirements and procedures for referring an Alliance member to a specialty primary health care provider.
In most cases, the referring provider must submit a Referral Consultation Request to the Alliance, via the Portal del Proveedor, in order to authorize the referral. Refer to the policy document for details.
The following special cases do not require prior authorization:
- All members may self-refer to the Emergency Department (ED) for emergency services, based on the member’s belief that they have an emergency.
- Certain ED referrals to specialists (see below).
Contact Provider Services
Billing questions, claims status, general claims information
General authorization information or questions
Checking the status of submitted authorizations
Authorizations, general pharmacy information or questions