Why do I need a referral to see a menopause specialist with an HMO or EPO plan?

HMO and EPO insurance plans require a referral from your primary care provider (PCP) before they will cover visits with a specialist. Without a referral on file, claims submitted to your insurer for specialist visits may be denied.

What is a Menopause Society Certified Practitioner (MSCP)?

A Menopause Society Certified Practitioner (MSCP) is a clinician who has completed specialized training in hormone management and menopause care and has been certified by The Menopause Society, formerly known as the North American Menopause Society (NAMS) — the leading professional organization for menopause care in North America.

What if my PCP says they can manage my menopause care themselves?

It is completely appropriate to acknowledge your PCP's offer and still request the referral. You might say: 'I appreciate that — I'd still love a referral for a specialist opinion to make sure I'm getting the most current care for this.'

What provider information does my PCP need to submit the referral?

Your PCP's office will need the following: Provider name — Kristen Bernal, MSN, APRN, FNP-C, MSCP. NPI number — 1770131369. Practice — Liv HRT, 4107 Medical Pkwy, Ste 208, Austin, TX 78756. Phone — 512-814-6642. Fax — 888-412-2171.

HMO & EPO - PCP Referral Request Tips

For patients with HMO or EPO plans

Requesting a Referral for an MSCP from Your PCP

If you have an HMO or EPO plan, your insurer requires a referral from your primary care provider (PCP) before we can submit claims for your visits. Requesting one is usually straightforward — especially when you mention that you want to see a Menopause Society Certified Practitioner.

What to say when you call

"Hi, I've been experiencing symptoms I believe are related to perimenopause or menopause — things like [hot flashes, sleep issues, brain fog, mood changes]. I'd love to see a specialist who focuses specifically on this area.

I'm hoping you can refer me to a Menopause Society Certified Practitioner. They're clinicians with specialized training in hormone management and menopause care, and I'm interested in exploring hormone therapy as part of my treatment.

Would you be able to put in that referral for me?"

Provider & practice information for the referral

Kristen Bernal, FNP-C, MSCP

Liv HRT · 4107 Medical Pkwy, Ste 208, Austin, TX 78756

NPI #

1770131369

Phone

512-814-6642

Fax

888-412-2171

A few things to keep in mind

How to reach your PCP

You can make this request by phone, through your patient portal, or at your next appointment — whichever is easiest.

If they're unfamiliar with the MSCP credential

let them know it's issued by The Menopause Society (formerly NAMS), the leading professional organization for menopause care in North America.

If your PCP offers to manage your care themselves

it's completely okay to say:

"I appreciate that — I'd still love a referral for a specialist opinion to make sure I'm getting the most current care for this."

Once the referral is submitted

ask for the referral number and pass it along to us. We'll handle everything from there.

Need help along the way?

If you run into any trouble or have questions, don't hesitate to reach out — we're happy to help.

Requesting a Referral for an MSCP from Your PCP

What to say when you call

Provider & practice information for the referral

A few things to keep in mind

Hormones and The Gut

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