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Specialist Referral Process

HCP’s Preferred Specialist Physicians and Centers of Excellence (COE)

Preferred Specialist Physicians

Using high-level data analytics, HCP has identified more than 6,500 Preferred Specialist Physicians across all non-hospital specialties to serve as the core of our referral network.

These high-quality providers work with our PCPs to offer excellent care with a preference for providing care outside of the hospital setting whenever possible.

Referrals to Preferred Specialists is done with ease; no referrals or authorizations are needed for PCP-to-Preferred Specialist referrals, nor for Preferred Specialist-to-Preferred Specialist referrals.

It is important that our providers refer their patients to in-network specialists. Referring to this network of vetted specialists will allow you to provide the highest quality of care to your patients in a timely fashion. By using in-network specialists, care transitions are improved, preventing unnecessary hospitalizations, readmissions, and duplications of effort resulting in more effective use of your time and resources.

Centers of Excellence

An elite subset of Preferred Specialists, our Centers of Excellence provider practices offer the highest level of collaboration and service to our providers and members.

Referrals to Preferred & COE Specialists

Referrals to Preferred Specialists is done with ease; no referrals or authorizations are needed for PCP-to-Preferred Specialist referrals, nor for Preferred Specialist-to-Preferred Specialist referrals. You can have your patients see any one of these Preferred/COE specialists, for as many visits as are required to keep your patients stable and in good health.

To ensure you are referring to a Preferred Specialist, use the Preferred Specialist Search tool to locate a provider by specialty, geography, and/or name.

By having your patients see Preferred Specialist Physicians you are giving them the best opportunity to remain healthy and stable without the added unnecessary cost of hospital-based services. In the rare situation that you are unable to find the outpatient care you need within the HCP Preferred Specialist list, a referral to a NON-Preferred Specialist provider will require a Prior Authorization to be submitted to HCP by the PCP.