Request Referral

Request Referral Online

Established patients can request non-urgent referrals online from all physicians EXCEPT:

 

    • OB/GYN - request online from Dr. Friedman; others by telephone only
  •  

    Online messages are not intended for emergency or urgent situations.

    Please call us by phone if you need a response in less than two business days.

    If you send an online referral request, please try to make it clear if you are:

     

    • requesting referral authorization needed for your insurance; or
    • requesting advice from your physician.
  •  

    This will help us triage your request to get you a faster response.

    See Referral Procedures section below before requesting a referral for insurance.

    Contact Referral Department by Phone

     

    • 312-926-DOCS (3627) and follow prompts for referrals.
    • For OB/GYN contact Gloria Aponte at 312-926-9011 or 312-926-8811.
  •  

    Referral Hours:

     

    • Monday - 11 a.m. to 4:30 p.m.
    • Tuesday - Friday - 9 a.m. to 4:30 p.m.
  •  

    Referral Procedures

    Most HMO and POS plans require that all care be provided or authorized by your primary care physician (PCP). You will need to obtain a referral from your PCP for any specialty services. Unauthorized specialty care may be denied by your managed care plan and the costs transferred to you.

    PPO PLANS may now require a prior authorization (not a referral form) for some services depending on your employer. If an authorization is required by your plan it is your responsibility to notify the referral department after you've contacted the insurance company to verify benefits and if pre-approval is required.

    All referrals must be called in at least three to five business days prior to your appointment as referrals normally take three to five business days to process depending on your insurance plan. Failure to obtain the referral prior to your appointment may result in you being asked to reschedule your appointment or you may be held financially responsible for that visit.

    All OB/Gyn referrals are handled by Gloria Aponte at 312-926-9011 or 312-926-8811

    Please follow these guidelines to obtain a referral:

     

    • After your Primary Care Physician refers you to a specialist or facility, schedule an appointment with that specialist or facility.
    • Once that is complete, please contact the:
      • NMPG Referral Department at 312-926-3642
      • or by sending a referral request to your physician online in Relayhealth.
    • You will need to provide all the information below:
      • Name
      • Daytime phone number
      • Name of Specialist/Facility
      • Reason for the Referral
      • Date of Appointment
      • Name of PCP/MD referring you
      • Name and type of your Insurance Plan
      • Fax number to the provider of service otherwise the referral will be mailed to you
  •  

    RETRO REFERRALS

    You must contact the Referral Department prior to the scheduled visit, as RETRO REFERRALS CANNOT BE PROCESSED. If you fail to do so, you may be held responsible for those charges.

    ONLY SERVICES SPECIFIED ON THE REFERRAL FORM ARE COVERED BY YOUR PLAN

    Your PCP must coordinate any additional services the specialist recommends such as: radiological services, surgery, physical therapy, etc. Please contact the Referral Department for all additional referrals.

    EMERGENCY ROOM VISITS

    In case if an emergency we suggest you notify your PCP before going to the ER. If this is not possible, please contact your PCP within 24 hours.

    ** A referral is not a guarantee of payment and does not authorize benefits for non-covered services. To verify covered benefits, please call your insurance plan. **

    Drupal 6 Appliance - Powered by TurnKey Linux