AvMed Authorization and Referral Tool (AART)
Your patients trust their health to you. We trust it, too.
Primary Care Physicians (PCPs) play a critical role in the health of our Members and are in the best position to coordinate their health care needs.
With the launch of our web-based portal for AvMed Providers, AvMed Authorization and Referral Tool (AART), PCPs will provide referrals for AvMed Members to access most specialty care services. PCPs will access the referral system to create and verify referrals, while Specialists will access it only to verify referrals. A referral does not require AvMed’s approval. It has been established to promote better communication and coordination between treating physicians.
Alert: Effective, November 1, 2023 PCP to specialist referrals will resume for the following plans:
- AvMed’s Engage and Entrust Individual and Family plans
- AvMed’s Medicare Advantage Plans Choice, Circle and Premium Saver plans
Important: As a reminder, AvMed’s Engage and Entrust Individual and Family plans require Members to obtain a referral from their PCPs for most Specialist appointments. Your patients can access a list of Specialists requiring a referral in the documents listed below.
With the End of the COVID-19 Public Health Emergency, effective August 1, 2023, AvMed will be reinstating its PCP to Specialist referral requirement for Medicare Advantage Plans Choice, Circle and Premium Saver.
To increase ease of the referral process, we've also increased the amount of time a referral is valid for from 90 days to 180 days. The AvMed authorization and referral tool can accept referrals now for August 1, 2023 and beyond.
See the documents below for more information:
P2P Referral Guidelines
Quick Reference Guide
List of Specialties Requiring a Referral