At Metrolina Eye, we strive to make the referral process as smooth and efficient as possible for our referring doctors. We offer three (3) convenient options to accommodate your preferences and streamline the process of sending a patient to our care. Our goal is to contact patients within 24 hours. Please be advised, Medicaid can take up to 72 hours to process for eligibility.
Regardless of the method you choose, our goal is to ensure a smooth transition for your patients and to provide them with the highest level of care. We appreciate your trust in referring your patients to Metrolina Eye and look forward to working together to support their eye health needs.
Option #1: Online Request Form through Phreesia Connect (Preferred)
For the most seamless and efficient referral experience, we recommend using our online request form through Phreesia. This method allows you to submit patient information quickly and securely, reducing paperwork and ensuring immediate processing. Simply click the link below to access the form and follow the prompts to complete your referral:
If you would like a convenient way to digitize and track your referrals to Metrolina Eye Associates, we recommend Creating a Free Phreesia Connect Account.
Option #2: Download and Fax the Referral Form
If you prefer a more traditional approach, you can download our referral form in PDF format, complete it, and fax it to us. This option is ideal if you have specific paperwork requirements or prefer handling referrals offline. Download the form from the link below and send it to our secure fax number:
Referral Team Fax Number: 704-635-7784
Option #3: Call or Email Our Referral Department
For those who prefer direct communication, you can reach out to our referral department via phone or email. Our dedicated team is available to assist with any questions you may have or to facilitate the referral process:
Phone: 704-774-1165
Email: referrals@metrolinaeye.com
Required Information for a Successful Referral
- Referring provider’s name, address, phone number, practice name, email address, and NPI number
- For appointment confirmation, Metrolina Eye must have provider’s direct fax number
- The “Meaningful Use Act” requires the following patient demographic information
- Date of Birth
- Race
- Ethnicity
- Gender
- Language
- A copy of the medical insurance card, front & back side; and if applicable, their vision plan insurance
- If patient is not policy holder, insurance subscriber’s name and date of birth
- If an insurance referral is required, the patients primary care physician (PCP), which is listed on the card, must issue the referral prior to the patients appointment.
- Copy of the exam notes with the diagnosis and list of all current medications.
- If you have your own referral form you prefer to use in lieu of our provided Referral Form, we will accept the form with all attached visit notes only if all the above information is included.
If you have any questions about the referral process or need assistance, please do not hesitate to contact our team. Thank you for collaborating with us in providing exceptional eye care.