You can book a Pain Management appointment at Mountain View Pain Center yourself, in either state, without a referral from another doctor. The same is true of Physical Therapy, Chiropractic and Acupuncture.
That is the answer to the question most people are actually asking. The longer answer is that "do I need a referral" and "will my insurance pay without one" are two different questions, and only the second one ever causes trouble.
Can the clinic see me without a referral? Yes. Neither Colorado nor Arizona requires a referral for a patient to be seen by a pain management physician, a chiropractor, a physical therapist or an acupuncturist. You send the form or call, and you get an appointment.
Will my plan pay without one? That depends on your plan, not on the state and not on the clinic. Some plan types want a referral on file before they will cover a specialist, and if yours is one of them, the referral is a paperwork step rather than a barrier.
We cannot tell you what your individual policy says, and we would rather you heard it from your plan than from us. The number on the back of your insurance card gets you a definite answer in a few minutes. The question to ask is: "Do I need a referral or prior authorization to see a pain management specialist?"
A referral is a note from your primary care physician to your plan saying a specialist visit is appropriate. It is usually sent electronically, it usually takes a day or two, and at most practices it does not require you to be seen in person first.
Prior authorization is different: it is your plan approving a specific procedure in advance. It is far more common for injections and other interventional procedures than for an initial consultation, and it is something we handle on your behalf when a procedure is recommended.
When you send an appointment request, we verify your benefits before you come in. That check covers whether your plan is one we are in network with, whether a referral or prior authorization is needed or already on file, and what your share of the cost is likely to be.
If something is missing, we tell you before the appointment rather than at the front desk. Mountain View Pain Center accepts most major insurance plans and is in network with most Medicare Advantage plans. Because plan networks change, we confirm yours specifically rather than asking you to take a general statement on trust.
Paying out of pocket? Then none of the above applies. No referral, no prior authorization, no plan rules. You book, you are seen, and you are told the cost before anything is done.
Even where it is not required, arriving with something from a previous clinician speeds up the first visit, most usefully imaging. If you have had an MRI, CT or X-ray of the painful area, bring the report, or tell us where it was done so we can request it. That way the first appointment is spent on a plan rather than on ordering a scan you have already had.
Previous Physical Therapy notes, a list of what you have tried, and whether each helped are worth as much as a formal referral, and they take thirty seconds to write down. Appointments are usually available within the same week.
Every clinic below has Chiropractic, Physical Therapy, Acupuncture and Pain Management on one chart, so care can move between them without a new referral.
Downtown out through the north, west, south and east suburbs.
Academy, Interquest and Tenderfoot cover the north, central and south of the city.
Harmony in Fort Collins and our Greeley clinic serve Larimer and Weld counties.
Across the Valley, from the West Valley through Phoenix to the East Valley.
No. Colorado does not require one, and Mountain View Pain Center does not require one to book. Some insurance plans, HMOs in particular, require a referral before they will pay, so check your plan.
No. The same answer applies in Arizona. The rule that matters is your insurance plan's, not the state's.
Original Medicare does not require a referral to see a specialist. Medicare Advantage plans often do, because many are structured as HMOs. Check the plan directly.
A referral is your primary care physician telling your plan that a specialist visit is appropriate. Prior authorization is your plan approving a specific procedure in advance. Referrals apply to visits; prior authorization usually applies to procedures, and we handle it when one is recommended.
No. Care after a crash does not require a referral, and it is normally billed to med-pay, a health plan, or against the claim.
Pain Management, Physical Therapy, Chiropractic and Acupuncture are all available without a referral at Mountain View Pain Center clinics across Colorado and Arizona. Appointments are usually available within the same week.
