Referrals and authorizations
If you have an HMO, your personal care physician (PCP) will direct you to a specialist (Dermatology; Ear, Nose and Throat, Cardiology etc.) and submit a referral to us. Most common specialty procedures do not require approval by HAP so you can get to the specialist sooner without waiting for approval. When approval is required, most HAP physicians participate in a “paperless” system when directing their patients to a specialist. This means you will not have a physical piece of paper to take to the specialist.
You do not need a referral if you have a HAP PPO plan, but your PCP would be a good resource to find a specialist who is right for you. With a PPO plan, you have the flexibility to seek care from doctors in or out of the network. But remember, you might pay a little bit more if you choose a doctor outside of our network.
If your doctor recommends an in-patient hospital visit or a medical test that's not an emergency, he/she will obtain authorization (or precertification) from us before you go to the hospital.