Primary care providers must use the Maryland Uniform Consultation Referral Form (PDF) when referring MedStar Family Choice members to Specialists. The forms are valid for 180 days. Complete the referral form in its entirety and the authorizing signature box must be signed by the PCP. Give the original to the patient and fax or mail a copy to the specialist. Keep a copy in the member's medical record.

A specialist cannot refer to another specialist without authorization from the PCP. If a specialist determines that another specialist needs to be consulted, he/she must contact the patient’s PCP for verbal or written approval. After receiving approval, the specialist should complete the Uniform Consultation Referral Form. The Specialist must clearly indicate the PCP’s approval on the referral. Exception: Specialists should directly refer members to participating providers for routine radiology, laboratory testing, rehabilitation, and DME services.

For laboratory services, providers must use a LabCorp requisition form. For radiology services, providers may use a radiology requisition form, a script or the Maryland Uniform Consultation Referral Form to refer to an in-network radiology center.

Information current as of: