Your PCP will provide you with a referral if you need the care of a specialist. Always contact your PCP first for any care you need. If you prefer a specific specialist who is participating with BlueLincs, you may want to select a PCP from the specialist's affiliated medical group. You must have a referral from your PCP before seeing any specialist. You must have a referral from your PCP before seeing any specialist.
Referrals are valid for a specific period of time or number of visits.
If the specialist determines that you will need more visits or another referral beyond the authorized period, he or she will work with you and your PCP on getting the care authorized. You should always contact your PCP before receiving additional care to make sure the services are authorized. BlueLincs has an appeals process in place for resolving complaints. Level 2 - If you are not satisfied with Level 1 determination, another appeal may be made to BlueLincs Grievance Committee. After all internal BlueLincs appeal procedures have been exhausted, claims may be externally reviewed by an independent organization.