Specialist Referrals

Date: 02/09/18

Thank you for your partnership with Ambetter from Sunflower Health Plan.  We are excited to be serving patients in Kansas, and want to ensure that our members have thorough access to the care that they need.  With that in mind, we are writing to clarify our policy on specialist referrals. 

Ambetter from Sunflower Health Plan encourages our members to develop and maintain a close partnership with their primary care provider (PCP), who is responsible for coordinating the member experience across the continuum of care. This patient-centered medical home concept promotes the PCP as the “quarterback” who guides the member across all care settings. While referrals are not required to be reported to Ambetter, we encourage the PCP to coordinate all referrals for the member when a specialty care is needed.

This ensures that the PCP is aware of all care settings in which the member is treated. 

If you have any questions or concerns about this or any aspect of delivering care to Ambetter from Sunflower Health Plan members, please don’t hesitate to reach out to Provider Services at 1-844-518-9505.