Providers
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Referral submission rules

Independence does not accept paper referrals with HMO/POS claims for payment. Any paper referrals submitted will be returned to the issuing provider without payment.

Note: Effective for dates of services on or after January 1, 2018, we no longer require any Medicare Advantage HMO members to obtain a referral from their primary care physician (PCP) when they need to see an in-network, participating specialist. This includes all Keystone 65 Focus HMO, Keystone 65 Preferred HMO, Keystone 65 Select HMO, and Keystone 65 Basic HMO members.

PCPs

All referrals should be submitted through PEAR Practice Management (PM) on the Provider Engagement, Analytics & Reporting (PEAR) portal.

Specialists

Please check PEAR PM to ensure that a referral was received for a member before services are rendered. Specialist are not permitted to accept paper referrals.

PEAR portal

Register online for the PEAR portal. If you have questions, you can submit a Provider eBusiness Inquiry Form.