Referral

Derivación

In 9 languages

LanguageTerm
EnglishReferral
Spanish (Español) Derivación
Chinese (中文) 转诊
Korean (한국어) 의뢰서
Vietnamese (Tiếng Việt) Giấy giới thiệu
Filipino (Tagalog) Referral
Portuguese (Português) Encaminhamento
Thai (ภาษาไทย) ใบส่งตัว
Japanese (日本語) 紹介状

What it means

A referral is a formal recommendation or authorization from your primary care provider (PCP) to see a specialist or receive a specific service. HMO plans generally require a referral for specialist visits to be covered; PPO plans often do not. A referral typically contains patient information, the reason for the visit, and relevant clinical history. Without a required referral, the specialist visit may not be covered by insurance, leaving the patient responsible for the full cost.

How to say it

Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:

My PCP gave me a referral to see a rheumatologist — will my HMO cover the visit?

Mi PCP me dio una derivación para ver a un reumatólogo — ¿mi HMO cubrirá la visita?

The specialist office said they need my referral number before scheduling my appointment.

El consultorio del especialista dijo que necesitan mi número de derivación antes de programar mi cita.

Without a valid referral, my HMO plan will not cover any of the specialist charges.

Sin una derivación válida, mi plan HMO no cubrirá ninguno de los cargos del especialista.

Where you'll see it

Referral formInsurer member portalExplanation of Benefits (EOB)Specialist appointment confirmation

Related terms

Related guide

→ US Guide: prior authorization and referrals

Sources

US Glossary Español A–Z US Codes United States

Last reviewed: September 2026