Is a referral and an authorization the same thing?
No, a provider can issue a referral but cannot issue an authorization. An authorization can only be issued by Network Health Plan. If services require an authorization a provider must call on behalf of the member and request an authorization from NHP.
If you have a POS plan and are utilizing your out-of-network benefits you may call and pre-authorize your own services. Authorizations must be obtained prior to receiving care.
