Your Primary Care Physician (PCP) manages all of your healthcare needs. If your PCP feels you need care from a specialist, you will be referred to one of the doctors in our SeaView IPA network.
Female patients of all ages may to go one of our OB/GYN specialists for routine, ongoing care – without a referral from their PCP. You may select your OB/GYN from our list of contracted providers or ask your PCP for a recommendation.
If you are – or become – pregnant, your OB/GYN will care for you throughout your pregnancy and delivery.
Once your PCP determines that you need care from a specialist, he/she will submit a pre-service authorization request to us. If you have already seen the specialist, he/she may submit a pre-service authorization request directly to us for the continued care and/or additional tests.
Our Authorizations team, along with a Physician Reviewer, will review your physician’s request – taking into consideration your medical condition, treatment needs and other pertinent issues. They will also review your health plan’s benefits, and any conditions that must be met as well as any exclusions and limitations that may apply.
Authorization decisions are based on nationally recognized, objective standards, criteria and guidelines, which have been developed from sound medical evidence. Please note: if your health plan does not cover the services that have been requested, we do not have the authority to approve them.
Once a decision is made, you will be notified in writing. If you have any questions about a review decision, or wish to obtain information about the review of the request, please contact our Member Services team at (805) 988-5188.
SeaView IPA is contracted exclusively with Quest Diagnostics for routine laboratory services. Your physician is able to submit laboratory test requests directly to Quest on your behalf, and without the need for a preservice authorization, for most services.
Quest has many convenient locations throughout Ventura County and offers both online and telephonic appointment booking, walk-ins are also welcome – but appointments take priority.
To identify a location convenient to you, and to schedule an appointment, please call (866) 697-8378 or visit www.questdiagnostics.com.
SeaView IPA is contracted exclusively with Rolling Oaks Radiology, a part of the RadNet family, for radiology and imaging services. Your physician is able to submit requests for routine x-rays directly to RadNet on your behalf and without the need for a preservice authorization. Imaging services, such as a CT scan or MRI, require preservice authorization which your physician will facilitate on your behalf.
RadNet has many convenient locations throughout Ventura County and offers both online and telephonic appointment booking.
To identify a location convenient to you, and/or to schedule an appointment, please call (805) 778-1513 or visit www.RollingOaksRadiology.com.