Referral Process

How It Works For You!

Self Referrals

Members can choose a Specialty Provider from our Self Referral Specialty Network Provider listing for the services listed below. You choose when you want to see the specialist. It’s that simple!
  • Annual Well Woman Visits
  • Gynecology
  • Health Education
  • Optometry
  • Vasectomy
  • Routine Hearing Tests for Medicare Advantage Plan (MAP*) (Senior HMO) members
  • Annual Mammogram for women 40 years old or over ??Patient Education (Bright Beginnings (Prenatal), Living With Asthma, Living With Congestive Heart Failure, Nutrition, Diabetic Education, Weight/Cholesterol Management)
  • Nail Care for MAP* (Senior HMO) members (Note: Members with the following medical conditions must consult their Primary Care Provider: Diabetes, Peripheral Vascular Disease, Skin Ulcers or Open Sores, Fungal Infections, Cold Feet (Raynaud Syndrome)
  • Dermatology Consultation MAP* (Senior HMO) members can now self refer once every 12 months
  • Mental Health for our Seniors (except Healthnet Senior Medicare Programs) may self refer to Windstone Behavioral Health

Direct Referrals

We've made referrals to our Direct Referral Network Specialists fast and simple for you and your Primary Care Provider! If your Primary Care Provider feels that a referral to a Specialist is needed, he/she can refer you directly for care with no additional authorization needed. The specialties listed below are available to you through your Primary Care Provider and Direct Referral.
  • Annual Mammogram for women 39 years old or younger
  • Dermatology
  • Health Education for 1:1 Counseling
  • Geriatric Assessment (Seniors Only Evaluation Clinic)
  • Hospice
  • PFT's
  • Pulse Oximetry
  • Pharm. D. Consultative Services
  • Routine Lab
  • Routine X-ray
  • Social Service Consultative Services
  • Spirometry

Prior Authorization Referrals

(All other Specialties not listed above) A referral that is initiated by your Primary Care Provider or Specialist and is faxed to Desert Oasis Healthcare's Utilization Management Department for prospective review by the Utilization Review Committee.

Services available through Self, Direct & Prior Authorization Referrals must be rendered by an APPROVED NETWORK SPECIALIST.

NOTE: Authorized provider for some specialties is based on Primary Care Physician assignment.
  • Affirmative Statement About Incentives
    • Utilization Management (UM) decision making is based only on appropriateness of care and service and existence of coverage.
    • The organization does not specifically reward practitioners or other individuals for issuing denials of coverage or service care.
    • Financial incentives for UM decision makers do not encourage decisions that result in under-utilization.
*Medicare Advantage Plans (MAPs) (Senior HMO):Aetna Medicare, Anthem Blue Cross, Blue Shield, Care1st Health Plan, Easy Choice Health Plan, Health Net, Inter Valley Health Plan, SCAN Health Plan and UnitedHealthcare.

Call for a list of approved Referral Network Specialists.
Referral Department: 1-760-320-5134, 1-800-500-5215, 1-760-320-5764 TTY for the hearing impaired