503.659.4988
Referral and Prior Authorization Information
Northwest Primary Care's Referral and Prior Authorization team processes requests for NWPC patients, providers, and specialists outside of NWPC. Please see the information below for frequently asked questions regarding referrals and prior authorization requests. If your question is not answered or you need additional information, please give us a call at 503.353.1282.
Please note:
- The Referral Request Form is for specialist office use only. NWPC patients do not need to complete or submit additional forms.
- Referrals are not required for new patients. Please call 503.659.4988, Option 1 to establish care as a new patient at NWPC.Â
Information for Patients
How long will it take to process my Referral or Prior Authorization request?
Our team usually processes non-emergency referral requests within 7 to 10 business days. Once your referral has processed, you will receive a text message and a secure message to your patient portal.
You can find information about your referrals in your athenaOne patient portal account by logging in and navigating to My Health. Then, navigate to Health Reminders. (Important note: you must use a desktop browser to view this section of your patient portal. This information is not available using the athenaPatient mobile app).
Prior Authorization requests are usually processed within 2 to 14 business days. You can find information in the same section of your athenaOne patient portal account.Â
Our team is also happy to assist with questions over the phone.
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When is a referral necessary?Â
Your insurance company may require a referral from your primary care provider for non-urgent specialist visits, hospitalization, medical equipment, or other services. Your insurance plan determines which specialists and hospitals are in-plan. Since Northwest Primary Care does not make this determination, it is important that you contact your insurance carrier to verify that your referral is for an in-plan provider. This will ensure that you are not referred to an out-of-plan specialist or hospital, which could result in higher costs to you.
If your insurance company requires it, you must acquire a referral prior to receiving services. Separate referrals may be required for diagnostic and surgical procedures, so check with your insurance company before receiving these services.Â
How will I know when my referral request has been approved?
You will receive a text message and a secure message in your patient portal letting you know your referral has processed. You will then be directed to login to your athenaOne patient portal account to see your referral information.
To find referral information in your patient portal, login to your portal account and navigate to My Health. Then, navigate to Health Reminders. (Important note: you must use a desktop browser to view this section of your patient portal. This information is not available using the athenaPatient mobile app).
Please allow 7-10 business days for processing standard referrals. If your insurance requires a referral or prior authorization, they will send a copy to you.
Once I am referred to a specialist or other provider, when can I schedule an appointment?
You may schedule your appointment as soon as your referral request has been approved. You will receive a text message and a secure message to your patient portal letting you know when your referral has been approved.
To find referral information in your patient portal, login to your portal account and navigate to My Health. Then, navigate to Health Reminders. (Important note: you must use a desktop browser to view this section of your patient portal. This information is not available using the athenaPatient mobile app).
Additionally, you can always call our team at 503.353.1282 and we will be happy to assist you.
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How do I contact NWPC's Referral and Prior Authorization team?
Please call 503.353.1282 to reach the Referral and Prior Authorization team.
Our team is available Monday - Friday from 8:00 AM to 5:00 PM.
Our fax number is 833.428.6205.
Our mailing address is:
Northwest Primary Care
PO Box 22075
Milwaukie, OR 97269
Do new patients require a referral to establish care with a primary care provider?
No. To establish care with an NWPC provider, please give our Scheduling team a call at 503.659.4988, Option 1.Â
Information for Providers
Where can I access your Referral Request Form?Â
You can download a copy here: Referral Request Form
When you have completed the form, please fax it to our team at 833.428.6205.
Where can I find information about Medical Nutrition Therapy referrals to NWPC?
Northwest Primary Care accepts referrals for medical nutrition therapy to Jacqueline Abbott, RD. To refer a patient for medical nutrition therapy at NWPC, please complete the Medical Nutrition Therapy Referral Form and submit it via fax to our team at 833.428.6205.
Which insurance plans does Northwest Primary Care accept?Â
We accept most major insurance plans. To see more information about what insurance plans are accepted at Northwest Primary Care, visit our Insurance Information page.
How can I contact NWPC's Referral and Prior Authorization team?
Please call 503.353.1282 to reach the Referral and Prior Authorization team.
Our team is available Monday - Friday from 8:00 AM to 5:00 PM.
Our fax number is 833.428.6205.
Our mailing address is:
Northwest Primary Care
PO Box 22075
Milwaukie, OR 97269
Important Note for United Healthcare Medicare Advantage HMO Plans
United Healthcare Medicare Advantage HMO plans: Before providing
services that require a referral, specialists and other health care professionals should confirm a referral has been issued. Services provided without a referral are the provider’s responsibility and the member cannot be billed: Medicare Advantage referrals | UHCprovider.com
503.659.4988