Referring Providers

What to Include With a Referral

Complete and clinically specific referrals help spineTECH review the patient’s needs, identify an appropriate starting point, and reduce additional outreach to the referring office.

Patient and Insurance Information

  • Patient full name and date of birth
  • Current phone and contact information
  • Insurance card, member, and group information
  • HMO, VA, Medicare Advantage, workers’ compensation, or other plan details
  • Referral and authorization documents when required

Referral Validity

  • Referral issue and expiration dates
  • Authorized visits and authorization number
  • Authorized provider or practice
  • Approved diagnosis or service
  • Whether additional authorization is pending

Referrals that are expired, issued to the wrong provider, limited to another service, or missing required authorization may delay scheduling.

Clinical Information

  • Reason for referral, symptoms, duration, and areas affected
  • Relevant diagnosis codes and functional limitations
  • Current medications and previous treatment response
  • Clinical question the referring provider wants addressed

Supporting Records

  • Recent office notes and imaging reports or file access
  • EMG or nerve-testing and laboratory results
  • Operative, therapy, hospital, emergency, and specialist records

Describe the Clinical Concern, Not Just One Possible Service

When permitted by the patient’s insurance plan, describe the patient’s broader clinical concern rather than listing only a symptom, test, or possible treatment. Clear clinical detail can help spineTECH identify an appropriate starting point and reduce additional outreach to the referring office.

Leg Pain

Less Helpful

Leg pain

More Helpful

Evaluate persistent leg and hip pain with intermittent numbness, weakness, and difficulty walking. Assess for spine, neurological, peripheral nerve, or pain-related causes as clinically appropriate.

EMG

Less Helpful

EMG only

More Helpful

Evaluate radiating leg pain, numbness, and weakness. Perform EMG or nerve testing if clinically appropriate and provide recommendations for further care.

Broader clinical wording does not replace payer-specific referrals or prior authorization. Additional authorization may still be required for testing, procedures, therapy, or consultation with another specialist.

How a Complete Referral Can Support Coordinated Care

  1. 1. Referral and records
    Patient is referred for generalized hip or leg pain; records indicate numbness, weakness, or radiating symptoms.
  2. 2. Clinical review
    Review identifies a possible need for EMG or nerve testing; conservative treatment may include pain-management evaluation or physical therapy.
  3. 3. Coordinated next step
    Persistent or significant findings may lead to surgical evaluation, with additional payer authorization obtained where required.

The appropriate pathway depends on the patient’s symptoms, examination, test results, clinical judgment, and insurance requirements.