Glossary: referral

Written approval from your insurance carrier to receive medical care at Memorial Sloan-Kettering. Please note that a new authorization is needed for each type of service, such as chemotherapy, radiation therapy, MRIs, CT scans, outpatient surgery, and each admission.

An insurance company that issues policies and makes payments to medical providers for its members.

An insurance plan that contracts with a network of healthcare providers. Your financial responsibility is significantly less when provided in-network. EPOs, HMOs, POS, and PPOs are managed care plans.

Physicians, hospitals, or other healthcare providers who do not have a managed care contract with an individual's insurance company. When you receive care out-of-network, you will be financially responsible for that care.

The approval form you receive from your primary care physician for you to see a specialist or get certain services. In many managed care plans, you need to get a referral form before you get care from anyone except your primary care doctor. If you do not first get a referral, the plan may not pay for your care. Patients in HMO plans must also obtain authorization for treatment from the carrier prior to an appointment at an out-of-network facility.