You Were Referred… Now What?
Understanding referrals, delays, and how to advocate for your child’s care
You leave an appointment and your provider says:
“I’m going to place a referral.”
You nod… and then later realize you have no idea what happens next.
Days go by.
No call.
No appointment.
Maybe a message from insurance. Maybe nothing at all.
Many parents assume they’re waiting for the system to move forward on its own — but most of the time, referrals require a little navigation. Not because anyone did something wrong, but because healthcare is complicated and no one really explains the process.
This post will help you understand what a referral means, why delays happen, and what you’re actually allowed to do next.
First: A Referral Is a Good Sign
Parents often feel anxious when a specialist is mentioned. It can sound serious, or like their concerns are being passed off.
In reality, referrals are usually a sign of thoughtful care. Modern healthcare is highly specialized. A good provider knows:
what they manage regularly
what needs deeper evaluation
when another clinician has better tools or training
Referrals open the door to expertise — not dismissal.
What a Referral Actually Is
A referral is permission for specialized care.
It allows:
your insurance to cover a visit
a specialist to evaluate your child
additional testing or treatment if needed
But here’s the important part: A referral is not an appointment. Nothing is automatically scheduled. Instead, several systems have to connect first.
Who Is Involved Behind the Scenes
Once a referral is placed, there are usually three separate parties involved:
Your primary provider’s office sends the referral
Insurance reviews or approves it. There may be a prior authorization process
The specialist’s office schedules the visit
Because these are independent systems, delays are extremely common — and often invisible to families.
You Can Choose Your Specialist
Many parents don’t realize this:
You are usually not required to see the exact specialist listed on the referral.
In most plans, you can:
choose any in-network provider
call multiple offices
compare wait times
Large health systems often refer internally first because it’s simpler administratively. But internal doesn’t always mean fastest or best.
Sometimes calling a different in-network office can move an appointment from months away to weeks — or even days.
You’re not breaking rules by asking. You’re participating in your child’s care.
Why Referrals Stall
If you’ve ever felt like your referral disappeared into a void, you’re not imagining it.
Common reasons include:
Prior authorization required by insurance
Missing documentation
Fax or electronic transfer failures
Long scheduling backlogs
Incorrect referral routing
None of these mean you caused a delay — but they do mean passive waiting rarely works well.
What You Can Do (No Permission Needed!)
Advocacy doesn’t mean confrontation. It means actively participating in the process.
Here are appropriate next steps:
1. Call the Specialist Office
Ask: “Hi, I’m calling to check if you received a referral for my child and to ask about scheduling.”
2. Contact Your Insurance
Ask: “Can you check the authorization status for my child’s referral?”
Insurance can often tell you:
if approval is pending
if more information is needed
if another provider is available sooner
provide a list of alternative in-network providers
3. Ask About Urgency
If symptoms affect feeding, breathing, sleep, or growth, you can say:
“My provider was concerned about timing — is it possible to mark this referral urgent?”
4. Redirect If Needed
If wait times are long:
ask your insurance company for a list of in-network providers in your area
contact them for wait times
ask your referring provider to reroute the referral to your preferred provider
When to Follow Up Sooner
Contact offices earlier if:
symptoms worsen
feeding becomes difficult
weight gain is affected
breathing concerns exist
your provider indicated time sensitivity
You are not being difficult.
You are coordinating care.
Advocacy Is a Skill — Not a Personality Trait
Many parents hesitate to call because they don’t want to be pushy.
But healthcare navigation is not intuitive. It’s learned.
Every call you make:
clarifies the next step
prevents delays
helps your child access care sooner
You don’t need a certain personality to do this — advocacy comes from understanding and guidance.
If This Feels Overwhelming
You’re not alone. Referrals are one of the most common places families get stuck in pediatric care.
My role is to help parents understand the system, know what to ask, and move forward with confidence.
If you need help navigating referrals, insurance approvals, or finding the right specialist, you’re always welcome to reach out.