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Seeing a specialist

A specialist is a doctor who practices a certain area of medicine. Your PCP is trained to treat most medical problems. But there may be times when you need to see a doctor who is a specialist. The PCP will help you decide when to see a specialist and will help you see an AmeriHealth Caritas Louisiana specialist.

AmeriHealth Caritas Louisiana covers your visits to specialists in our network. There is no limit to how many times you may see these specialists.

Specialist doctors include:

  • Heart doctors (cardiologists)
  • Skin doctors (dermatologists)
  • Doctors for women and girls (gynecologists/GYN)
  • Doctors for women who are pregnant (obstetricians/OB/Birthing Centers)
  • Doctors for bones and joints (orthopedists)
  • Foot doctors (podiatrists)
  • Eye doctors (ophthalmologists)
  • Doctors that perform surgeries (surgeons)

Always check with your PCP before going to a specialist. Although a referral is not required to see an AmeriHealth Caritas Louisiana network specialist, your PCP will assist you in coordinating specialist care.  For a list of AmeriHealth Caritas Louisiana specialist doctors, call Member Services toll-free at 1-888-756-0004.

If you want more information about an AmeriHealth Caritas Louisiana provider, call Member Services at 1-888-756-0004. You can find out things like where the doctor went to medical school or if a doctor is board certified.

Out-of-network specialists

If you need to see a specialist who is not in the AmeriHealth Caritas Louisiana network, you will need to have prior authorization (pre-approval) from AmeriHealth Caritas Louisiana. Ask your PCP to help you get prior authorization.

Second opinion

If you want to know what another doctor says about your health problem, you may get a second opinion at no cost to you. If you want a second opinion:

  • Call Member Services toll-free at 1-888-756-0004 or ask your PCP for the name of another doctor who is an AmeriHealth Caritas Louisiana doctor
  • Call the second doctor to make an appointment

For help, call Member Services 1-888-756-0004.

Self-referrals

AmeriHealth Caritas Louisiana encourages you to coordinate your health care needs with your PCP.  However, you are not required to get a PCP referral to see an AmeriHealth Caritas Louisiana network specialist.