Seeing a Specialist

Seeing a Specialist

Your Primary Care Physician (PCP)

If you think you need to see a specialist

A specialist is a Doctor that has been trained as an expert in certain diseases or areas of the body. For example, an orthopedic specialist treats broken bones, joints and other problems related to bones and the skeleton.

Your Primary Care Physician (PCP) will suggest a specialist when needed. He will give you a referral. This is a written order given to you to see a different doctor.

Self Referral Services

In some cases you may be able to seek treatment without a note from your primary care provider. You can find a list of these services under Referrals and Authorizations or you can call Member Services at 202-821-1100 or 855-326-4831

When you must have a written approval

When you need special care, like a hospital admission or surgery, you need approval before you can get them. This is to be sure that you are getting the care you need and that is right for your condition. Your Doctor or Member Services must be contacted.

TRUSTED Health Plan (THP)

Your Local Washington D.C.
Managed Care Organization (MCO)

Call Member Services

(202) 821-1100

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