Canopy Health is making referral care easier and more efficient for our members — who can now access our entire alliance of physicians, hospitals, and care centers. And we’ve streamlined the system to make it easier to use and more affordable.
Keep reading to learn how all Canopy Health members have easy access to convenient referral care with excellent Bay Area specialists.
Why Might I Need a Referral?
Canopy Health delivers coordinated care to its members. This means your primary care physician (PCP) oversees all your healthcare and must refer you to specialists and other providers. If you seek non-emergency care without a referral, you may be financially responsible for the bills. However, we believe coordinated care helps our members achieve the best possible health outcomes.
When you build a strong relationship with your PCP, they might identify your chronic conditions, like diabetes and heart disease, early on. This early diagnosis, combined with high-quality preventive care, can help you avoid or delay serious complications. And when your PCP knows you well, they can connect you with the right specialists — taking both your medical needs and personality into account. When you seek treatment with the right specialists, you’re more likely to have a better outcome and patient experience.
Additionally, coordinated care can reduce your out-of-pocket healthcare costs. Other, more traditional, forms of healthcare sometimes allow people to seek treatment without a referral, but this can lead to unnecessary and duplicative care. If your physicians aren’t communicating with each other, they might order repetitive testing and treatment. This typically won’t improve your outcomes, but it will add to your out-of-pocket bills.
When your PCP coordinates your healthcare, they can ensure that you don’t undergo repetitive testing, examinations, and treatment. They’ll also share your healthcare information with your other providers, helping them understand your medical history and specialized needs.
Our Alliance Includes Many of the Bay Area’s Top Specialists
Canopy Health’s alliance of 18 hospitals, nearly 5,000 physicians, and numerous other outpatient care centers gives our members access to some of the Bay Area’s most respected providers. Our hospitals and medical groups offer nationally-recognized treatment in numerous specialties, including:
- Cancer treatment
- Cardiac care and surgery
- Diabetes
- Gastroenterology
- Geriatric care
- Neurology and neurosurgery
- Obstetrics and gynecology
- Orthopedics, including joint replacement
- Pulmonology
- Rheumatology
- Stroke treatment and rehabilitation
- Urology
As importantly, our alliance’s physicians and hospitals are deeply committed to refreshingly clear, human care. They strive to deliver an exceptional patient experience and with positive outcomes during every visit and appointment. To learn more about our alliance providers, hospitals, and care centers, please search our physician directory.
How Is Canopy Health Improving Referral Care?
In the past, getting a referral might have involved jumping through a lot of hoops and enduring a lot of headaches: multiple appointments with your PCP, numerous co-pays, and prior approval from your health plan. At the end of it all, you might have decided the referral wasn’t worthwhile. One study suggests that 20 to 40% of patients never follow-up on a referral.
Canopy Health, however, is constantly working to improve our members’ referral care experience. With our referral care system, the referral process is easy and automated.
- You schedule an appointment with your PCP to discuss your medical needs
- Your PCP refers you to the appropriate Canopy Health alliance physician — you are not limited to physicians within your PCP’s medical group
- For most services, an automated referral is sent to the specialist, and you will not be required to receive prior authorization from your health plan
- The specialist’s office will contact you directly to schedule your first appointment
And if you need help or have concerns, you can always contact your PCP or the Canopy Health contact center.
References
Forrest, C., Shadmi, E., Nutting, P., & Starfield, B. (2017, July/August). Specialty referral completion among primary care patients: Results from the ASPN referral study. Annals of Family Medicine. Retrieved from http://www.annfammed.org/content/5/4/361
