Sneezing. Itchy skin. A runny nose. Sound familiar? If you suffer from allergies, you're not alone. In fact, according to the American College of Allergy, Asthma & Immunology, more than 50 million Americans suffer from allergies each year.
With numbers like that, you would think it would be easy to find an allergist, right?
Unfortunately, that's not always the case. Sometimes, you may need a referral from your primary care physician to see an allergist. Other times, you may not need one at all.
In this article, we'll look closely at the ins and outs of referral requirements for seeing an allergist and provide some helpful tips on how to see an allergist.
What is an Allergist?
An allergist is a type of physician who specializes in the diagnosis, treatment, and management of allergic diseases. They are an allergy specialist specifically trained to understand and identify allergy triggers and to provide comprehensive care to patients with these allergic conditions.
An allergist generally completes four years of medical school followed by a three-year residency training program in internal medicine or pediatrics. They study various topics related to allergies, including immunology, biochemistry, and pharmacology. After completing their training, allergists must pass a rigorous examination administered by the American Board of Allergy and Immunology to become board certified in allergy and immunology.
What Can an Allergist Do?
Allergists are important in the diagnosis and management of allergies and are often able to provide solutions for patients. Through their deep understanding of the human immune system, allergists are able to identify the root causes of allergies and create personalized treatment plans that can provide long-term relief.
In some cases, allergists may also recommend or prescribe immunotherapy, which is a type of long-term treatment that can help to reduce a patient's sensitivity to their allergies. Immunotherapy can be administered as shots or sublingual immunotherapy and is often used to treat patients with severe allergies who have not found relief from other treatments.
Other services that allergists provide include:
- Allergy skin testing
- Education on avoidance and management of allergies
- Emergency care for severe allergic reactions
When Should I See an Allergist?
You should consider making an appointment with an allergist if you suffer from frequent or severe allergies or if you do not know what types of allergies you have. Allergists can also be helpful if your allergies are not responding to over-the-counter or home remedies.
Additionally, if you have a family history of allergies or asthma, you may be more likely to develop these conditions and may benefit from seeing an allergist.
If you think you may need to see an allergist, you can schedule a consultation with your primary care physician. They will likely be able to provide you with a referral to an allergist, though sometimes this process can delay your initial appointment with an allergy doctor. You can also schedule a consultation with an allergy specialist at Wyndly and get started with your allergy care right away.
What is a Referral?
A referral is a formal written request sent from one healthcare provider to another requesting that they diagnose or treat a patient's specific condition. This is usually done when a patient's general doctor is not able to treat the condition effectively or provide the specialized care required.
The referral may be sent directly to the specialist or a shared Intake Service, who will contact the specialist on the patient's behalf.
Referrals can sometimes be as easy as having your primary care doctor directly send information to who you're referred, but they can also be more complex. If you're being referred to a specialist who is not in your insurance network, your insurance company may require that you first get a "pre-authorization" from them before they agree to pay for any services.
Do I Need a Referral to See an Allergist?
You do not need a referral to see an allergist. Through Wyndly, you can schedule a consultation with an allergy doctor without a referral. Our doctors will work with you to identify your allergies and create a personalized treatment plan for long-term allergy relief.
Otherwise, it may vary depending on your insurance coverage. Those with Health Maintenance Organization (HMO) insurance plans will usually need a referral before making an appointment with a specialist.
On the other hand, those with Preferred Provider Organization (PPO) plans may not need a referral to see an allergist but may pay more out-of-pocket costs if they choose to do so.
In general, you won't need to get a referral if:
- You choose Wyndly
- You have a PPO health insurance plan
- Your primary care provider is providing the services you are seeking
- Your insurance plan doesn't require you to choose a primary care provider
- You have out-of-network benefits
- Your insurance plan gives you the ability to choose your own doctors
- You have a federal employee insurance plan
- You have traditional Medicare
However, you'll usually need one for cases where:
- You have an HMO health insurance plan
- Your insurance plan requires you to choose a primary care provider
- You got your health insurance plan through the Health Insurance Marketplace
- You have Blue Cross Blue Shield Advantage
- You have a Blue Cross Blue Shield of Texas plan starting with the letters: VER, ZGN, ZGZ, VEL, or ZGP
Of course, the best way to determine whether or not you need a referral is to check with your insurance company directly.
Do I Need a Referral for Allergy Testing?
Allergy testing is used to determine what a person is allergic to and can easily be done without a referral through Wyndly. Get an at-home allergy test today to identify what you are allergic to and meet with our allergy doctors for a personalized treatment plan.
If you are doing your allergy testing outside of Wyndly, you will likely need a referral from your primary care physician to have one. There are some additional exceptions. For example, if you have PPO insurance, you may not need a referral for allergy testing. Additionally, you may not need a referral if you have out-of-network benefits.
You can always check with your insurance company directly to find out if you need a referral for allergy testing or skip the wait and get tested through Wyndly.
How to See an Allergy Doctor Without a Referral
The world of referrals can be complicated. Luckily, there are alternative solutions that can make seeing an allergy doctor easier, even if you don't have a referral. At Wyndly, we offer a convenient and affordable solution that makes it easy to get the care you need without a referral.
Take our quick online allergy assessment today to learn more about your options and get started on your journey to better allergy care!