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What's the difference: Referrals vs. Authorizations?
Referrals and authorizations are two separate requirements. A referral is defined as the process of directing or redirecting (as a medical case or a patient) to an appropriate specialist or agency. An authorization is defined as an approval of medical services prior to services being rendered. It is important to remember that some plans will always require a referral, even for specialist services or tests on the standing authorizations list.
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