Referrals

Please call your CHA Primary Care Center anytime (day or night) to talk to your care team. Our nurses and doctors are always available to answer questions on the phone, even when the office is closed. If your health issue is not treatable by phone, you can almost always get a same or next day office visit.

If you feel your medical need is urgent, but not an emergency, try our new CHA Urgent Care Center, Somerville Campus. Or, we have several partners that may see you: Carewell Urgent Care and Beth Israel Deaconess Chelsea Urgent Care.

If you feel you are having a health emergency, dont wait. Call 9-1-1 or go to the nearest emergency room.

You can find 24 hour emergency care at CHA Cambridge Hospital and CHA Everett Hospital. CHA hospitals have some of the shortest ER wait times in Massachusetts.

When you go to a CHA emergency room, your CHA doctor will be notified about your health needs right away. This "coordinated care" is safer for you and important to us.

Start by talking to your primary care team. In many cases, they can treat you over the phone or with a simple office visit. Otherwise, they will refer you to the right service for your needs.

In order to give you the most coordinated care, our policy is to refer patients within CHA for specialty care whenever possible. This gives you coordinated care and allows your caregivers to work together closely.

CHA has excellent specialists and testing services. This includes board-certified doctors who trained at some of the nation's best hospitals, and services like CT, MRI, Mammography and Cardio-Pulmonary testing.

For highly complex health needs, we may refer you or your family member to one of our partner hospitals, Beth Israel Deaconess Medical Center (BIDMC) or Massachusetts General Hospital for Children (MGHfC).

Please talk to your CHA primary care team first. Health care works best when you have ONE TEAM working for you.

There are many doctors in your health plan network who are outside the CHA referral network. Many outside doctors do not share information easily and we cannot ensure the quality of their services.

No. If your insurance requires a referral, please request it BEFORE you see a specialist or have tests. Your primary care team may want to see you first.

You should also be aware of any costs. Many health plans require a referral ahead of time. Without this, you may have to pay all the visit costs (not just the co-payment or deductible).

Please call your CHA primary care center directly. For non-urgent questions, you can also send a MyChart message.

If you need to know what services are covered by your health plan, please contact your plan's Member Services team. The phone number is on your insurance card.

Cambridge Health Alliance (CHA) is part of a provider organization that is certified as a "risk-bearing provider organization" (RBPO) by the Massachusetts Division of Insurance. An RBPO is a group of health care providers that work together to coordinate your care and enter into financial agreements with insurance companies to do so. CHA is participating in an RBPO that is called the CHA Accountable Care Organization (ACO).

Per regulatory guidelines and as part of CHA's commitment to our patients, we have established a process for you or your authorized representative (such as a spouse, family member, friend, attorney or legal guardian) to make a complaint about issues like referrals, timely access to treatment or services or other concerns about limitations of care.

To ask about this appeals process or to file a complaint, please contact our Patient Relations Department.

You can contact our Patient Relations Department in the following ways:
To file a complaint by phone: 617-665-1398

To file a complaint in writing:

Cambridge Health Alliance
Patient Relations Department
1493 Cambridge Street
Cambridge, MA 02139
Fax: 617-591-4490

To file a complaint online: Click on "Contact CHA" in the navigation menu in the upper right and fill out our contact form. Or send an email to webmaster@challiance.org.

We will give you a written answer to your pre-service and post-service complaint/appeals in fourteen (14) business days. If your complaint involves urgent medical needs, we will give you a written answer in three (3) days.

For more information or questions, call 617-665-1398.

For more information on your right to make a complaint, contact the Massachusetts Office of Patient Protection at 800-436-7757.

Your CHA doctor may want to see you before writing a referral. This will let them evaluate your health and direct your care.

This more important if you are a new patient or haven’t been to your CHA primary care center recently.

If possible, please use a CHA hospital for your emergency. We have 24-hour emergency care for all ages at CHA Cambridge Hospital, CHA Somerville Campus and CHA Everett Hospital.

If you visit an emergency room at a hospital that is not part of CHA, you may see a non-CHA specialist as part of your care. You may also get a follow-up referral to that hospital. When your emergency is over, please call your CHA primary care team right away. They will want to know how you are feeling and can connect you to a specialist in the CHA network.

Most do. These vary by the company and type of coverage. For example, in some plans you can save money by seeing certain doctors (in network).

Plans like HMOs require that your primary care doctor choose a specialist for you. Plans with preferred provider (PPO) or point of service (POS) options may make you pay more to see a specialist that your doctor did not select. Other plans may make you pay the entire bill (not just a co-pay or deductible) if you see a doctor outside their network. If you have questions, please call your health plan’s Member Services.

We hope you never need specialty care when you are away. But if you do, please check with your health plan. Your insurance may have different rules about out-of-area medical services.

If you need to renew a prescription, please contact your primary care center by phone or MyCHArt. Your doctor may want to see you first, based on your medical history and symptoms.