Making a Referral

The following services do not require a referral from a Primary Care Physician

• Gynecological and obstetrical services rendered by an in-network provider
• Emergency care services rendered within 72 hours of an injury or sickness.
• Behavioral health services (which must, however, be pre-certified)
• Chiroselect services

Members are advised to notify their Primary Care Physician following a visit to an urgent care or an emergency room.

The Referral Process

If a referral is needed, as an OSU MHCS provider you must refer the member patient to another provider within the network. Any standard or referral consult form or other means of communication between you as the referring physician and the chosen consulting physician is acceptable. It is not necessary to send a copy of the referral to OSU MHCS.

If you need to verify whether a provider is participating in the network, call OSU MHCS at (614) 292-4700 or (800) 678-6269.

Any provider interested in referring a patient to, or talking to, a physician at The Ohio State University Hospitals or Arthur G. James Cancer Hospital regarding a medical concern may call the OSU ConsultLine at (800) 824-8236.

Out-of-Network Referrals

Any referral to an out-of-network provider must be pre-authorized by OSU MHCS. To obtain prior authorization, call OSU MHCS at (614) 292-4700 or (800) 678-6269.

Behavioral Health Referrals

While it is not necessary for members to obtain a referral for behavioral health services, these services must be pre-certified within one day following the date of service. Members are encouraged to inform their Primary Care Physician of any treatment that may affect them physically.