Referral Guidelines

For more information about SSN physicians and services or comments about how we can better serve you, please call our Referral Service at (888) 834-1788 or e-mail us at ssn@sutterhealth.org.

We look forward to serving your referral needs.

Facilitating Your Referral

To provide you with the most comprehensive communication and assistance, this section is designed to help facilitate your referrals to the Sutter Health network of hospitals and specialists in the Sacramento Sierra Region.

Following, you will find many helpful telephone numbers and a quick form that you may duplicate and use whenever you are providing a referral to a physician listed in this directory.

How to Refer a Patient to a Sutter Specialist

Sutter Specialty Services Network Referral Line
Phone: (888) 834-1788
Fax: (916) 733-0855
E-mail: ssn@sutterhealth.org

Please include the following information with the referral:

• Patient name, date of birth, address and telephone number
• Condition/diagnosis
• Specialty service being requested
• Referring physician
• Primary care physician
• Primary payer and authorization, if available

To expedite the referral process, please complete the Intake Patient Information form on page 4 and fax to (916) 733-0855.

Sutter Specialty Services Network will provide assistance with the following:

• Identification of the appropriate Sutter Health specialty service and Sutter SpecialtyService Network physician(s) for your patient
• Facilitating the transfer of care
• Assistance in appointment scheduling for the patient, providing maps or directions for the patient as needed
• Facilitate follow-up information regarding the patient
• Provide lodging information for family members from outlying areas
• Coordinate physician-to-physician calls
• Provide referral status reporting as requested

How to Transfer a Patient to a Sutter Facility

Call toll free (877) 777-6680

Please have the following information available when you call:

• Caller’s name and return phone number
• Name and telephone number of physician requesting transfer
• Patient’s name, date of birth, and patient’s current location
• Reason for transfer/diagnosis
• Specialty/specialist being requested
• Insurance information

Patient Access Center will:

• Verify insurance
• Verify bed availability at level of care requested
• Make initial contact with specialty requested
• Call you back with complete information regarding transfer

Billing and Claims

Claims Submission

• Network provider is responsible for ascertaining and collecting any co-payments as determined by the patient’s benefit plan.
• Network provider submits claim(s) to the address indicated on the patient’s I.D. card.
• Claims are to be submitted in the form of an accurately completed HCFA 1500 or UB92, as applicable, in conformance with Medicare billing guidelines.
• In accordance with the Sutter Specialty Services Network agreement, network providers will not balance bill the patient. Contracted rates, along with applicable co-payments and deductibles, shall be accepted as payment in full.

Claims Payment

• Payer shall remit payment attached to copy of the original claim to the network third party administrator.
• Network third party administrator will verify accuracy of payment and forward.
• Direct any questions regarding payment to the SSN Network and Data Coordinator at (916) 565-8615 (Monday - Friday; 8:30 a.m. to 5:00 p.m.).

Payment Tracking and Reporting

• The network third party administrator will track payments and periodically provide
  reports to Sutter Specialty Services Network administration summarizing payments by payer and by network provider.

Network Third Party Administrator
Benefit & Risk Management Services
P.O. Box 2650
Rancho Cordova, CA 95741-2650

Phone: (888) 326-2555 (Monday - Friday; 7:00 a.m. to 6:00 p.m.)
           (916) 858-2950 (Monday - Friday; 8:30 a.m. to 5:00 p.m.)
Fax: (916) 858-2970 or 858-2971 (7 days/24 hours)