top of page

Medical Referrals

​

Referrals to Specialist Providers:  

​

In the United States, optometrists like Dr. Kerry Atkins are considered specialists by health insurance companies. 

​

Many medical health insurance companies require that you get a referral from your primary care physician (PCP) if you want them to pay for the visit. Claims may be denied if the appropriate referral is not obtained and the claim may still be subject to your deductible if it has not been met.

 

You will need to reach out to your PCP in order to get a referral. Your PCP's office will help coordinate the visit with our office and they will also communicate that you have been referred to Dr. Kerry Atkins to the insurance company.

 

  • If Dr. Kerry Atkins needs to see you for multiple visits due to an injury or ongoing medical condition, you must make sure that the referral from your PCP covers more than one visit.
     

  • It is very important to check and make sure that the referral has arrived at our office before your appointment. If the referral has not arrived, the claim submitted for the appointment will be denied by your insurance. 

​

How do I know if my insurance requires a referral?

​

HMO plans and POS plans will require a referral before seeing a specialist. 

 

Dedicated vision insurance companies like Vision Service Plan (VSP), PPO, Open Access, and EPO plans do not require a referral. 

​

If you have coverage via TRICARE, please visit this website for more information:

 https://www.tricare.mil/CoveredServices/Vision/EyeExams

Please note, our office is only in network with FEDVIP vision via Blue Cross Blue Shield and VSP. 

​

What if I don't want to wait for a referral or need to be seen urgently?

You will need a referral if you want the insurance to pay for the visit.
​

  • If you need to be seen before your PCP writes a referral you can:
     

    • Pay out of pocket:

      • Our office charges $125 for an out of pocket eye exam. It's an additional $75 if you would also like to do the tests for a contact lens prescription. ​

      • Our office charges $75 for an urgent/same day medical appointment for eye injury or illness

      • You are welcome to submit the detailed receipt to your insurance for reimbursement if they offer that as an option. They may not offer reimbursement if a referral was required. 
         

    • Sign up for a vision insurance plan like VSP

  • If you are experiencing a medical emergency, please call 911 or visit an urgent care facility or the emergency room. ​

​

What if I don’t have a PCP?

​

You must have a PCP in order to get a referral for a specialist. 
 

  • If you do not have a PCP, you will need to pay out of pocket for your visit or get a vision insurance plan that may have specified copays. 

​

Some insurance companies will assign you a PCP, so you can call that doctor to make an appointment with them and ask about getting your referral for an eye exam. Remember:  PCP's will not write referrals for patients they haven't seen for an extended period of time. 

​

It's VERY IMPORTANT to make sure to get an updated insurance card if you change your PCP. The PCP printed on the issued insurance card is the PCP required to write your referral. This is especially true for Humana Insurance. If your issued card does not have a specified PCP, you should check your insurance portal to see if it's specified there.  

​

What information may need to be on the referral from my PCP?

​

  • Your demographic information and insurance details

  • Referred to Service Provider:

    • Kerry M Atkins, OD

EYEDENTITY Inc.

941 6th St S

Kirkland, WA 98033

Phone: 425-822-7685

Fax: 425-889-1664

Tax-ID: 91-1739043

NPI: 1366553141

  • Specialty: Optometry (NOT Ophthalmology) 

  • Procedure Ordered: Referral to Optometry (NOT Ophthalmology) 

  • Authorizing Provider:

    • Your PCP's information & NPI Number​

  • Diagnosis

  • Referral Reason

    • Specified by PCP, Examples: Standard/Routine Eye Exam, Diabetic Eye Exam, Cataracts, Medical Eye Exam

  • Referral Service: Consult, Evaluation, and Treatment

  • Referral Status / Authorization Number

  • Number of Visits

  • Service Date(s)

bottom of page