At South Shore Medical Center, our goal is to provide our patients with comprehensive care, including convenient access not only to your primary care provider team, but also to a wide range of services and specialists to help facilitate your care.
During the course of your care, you may find a time when you or your primary care provider think you need to be seen by a specialist. Seeking care from a specialist involves not only determining which specialist is right for your care, but also some administrative steps that may be required by your insurance company. Your South Shore Medical Center primary care provider team can assist you with both aspects of this process to help ensure that obtaining access to such care occurs as efficiently as possible.
If you think that you need to see a specialist:
- Please speak with your South Shore Medical Center primary care provider first. Even if your health plan does not require a formal referral, your primary care provider can help you determine an appropriate specialist for your care. The providers at South Shore Medical Center have a preferred group of specialists with whom they work. Referring within these established and trusted relationships will provide you with access to care that is well coordinated.
- If your health plan requires a formal referral, this referral should be requested and completed prior to your visit to a specialist. If you see a specialist without the referral required by your health plan, you may be responsible for the entire cost of your specialist visit/care (not only the co-payment or deductible).
- Referrals may be requested during your visit or by calling your South Shore Medical Center primary care provider/team, or through the MyHealth Online patient portal. If a referral is placed while you are seeing your primary care provider, you will be asked to stop at our check out desk after your visit to obtain the contact information for the specialist. If a referral is requested by your primary care provider after you have left your visit, you will be contacted by our Referral Department with the contact information for the specialist.
- After scheduling your specialist appointment and prior to your visit with the specialist, please call South Shore Medical Center’s Appointment Voicemail Line (781-792-4183) with your specialist appointment information. This step is essential in ensuring that our staff can complete the formal referral process by obtaining authorization from your insurance company and sending the completed referral to the specialist.
- It is important to note that any change in your insurance will affect your referral. Be sure to contact South Shore Medical Center when you have any changes to your health insurance plan.
- Coverage for out-of-network medical services varies widely by insurance company and product type (e.g., HMO, POS). Please consult your insurance company for specific information about what services are or are not covered before seeking non-emergency care.