As part of our commitment to making our health plans easier to use, we’ve introduced “open access” for our HMO and Point-of-Service (POS) members. Open access gives members direct access to in-network physician specialists without a referral from their primary care physician (PCP).
Although members must still select a PCP, they may visit any physician specialist in our extensive HMO Colorado provider network
simply by scheduling an appointment directly with that specialist. Point-of-Service (POS) members are not required to obtain a referral when visiting an out-of-network physician specialist but will pay a greater share of the cost for this type of visit.
Although in-network physician specialist visits do not require a referral for HMO or POS members, preauthorization requirements remain the same. Preauthorization
is required for:
We encourage members to continue consulting their PCP to coordinate their health care and for referral recommendations. PCPs help ensure quality and consistency in our members’ overall health care.