If you are looking for the best care for kids in California, choose Children’s Hospital Los Angeles. We’re here to help you find the experts you need to provide outstanding specialty care for the children in your life.
Why We Ask for Referrals and Authorization for Care
Many insurance companies require a pre-authorization or referral for your child to be seen by a specialist. If your family's plan requires this, you should make sure that authorizations or referrals are taken care of before you receive services at Children’s Hospital Los Angeles. This process will be different depending on the type of health insurance coverage your family has.
You may be able to schedule services before receiving notice of authorization. The service may be canceled or rescheduled if authorization is not approved by your insurance company in time for the appointment. If your insurance company needs a referral or prior authorization, call your primary care doctor before scheduling an appointment with us.
Types of Health Insurance
If you are enrolled in California’s Medi-Cal program or another state’s Medicaid program, a treatment authorization request (TAR) is required. This process is governed by state and federal law and Children’s Hospital Los Angeles is required to request authorization before providing non-emergency medical services to your child. Your pediatrician will know how to submit a TAR for Children’s Hospital Los Angeles. Out-of-state patients covered by Medicaid should consult their state program guidelines.
PPO and EPO Insurance Coverage
If your family is insured through a Commercial Preferred Provider Organization (PPO) or an Exclusive Provider Organization (EPO), you do not need an authorization from your child’s doctor, but we may need a referral packet to determine the medical urgency and appropriate physician for your child.
Request an appointment here and we will let you know what information you need to bring to your CHLA visit.
HMO Insurance Coverage
If you have insurance provided through a health maintenance organization (HMO), our staff will work with you to ensure that you have received a referral from your primary care physician before your appointment. Once the referral has been obtained, you or your Primary Care Physician can call, fax or email the referral documentation to us.
California Children’s Services (CCS)
If you are enrolled in the California Children’s Services (CCS) insurance coverage program, a service authorization request (SAR) is required. This process is governed by state and federal law and Children’s Hospital Los Angeles is required to request authorization before providing non-emergency medical services to your child.
Patient families who live outside the United States can start by filling out this intake form to request review of your child's condition by our International Patient Services team. After the form is filled out, a team member will reach out by email or phone.
What to Bring With You
We often request that parents or referring pediatricians provide additional detailed health information before first-time visits. Our staff will tell you what to bring with you. Examples include:
- Medical records from visits with other doctors or medical experts
- X-ray files
- Lab results
- Medication list (including medication strengths and amounts taken, for prescription and over-the-counter medication) or bring the original medication bottles with you
- Information about your child’s allergies