Referrals

Referral Process Summary (as of September 2025)

OT, Speech therapy: please use Staff Messaging and SmartPhrases to place referrals (for any insurance, any location).
Physical therapy: you may use Staff Messaging OR place referrals directly. Please see below for details based on insurance plan.
Patients with HPSM insurance can be referred to medical specialties (not OT, PT, or Speech) at LPCH via CERM. (see referral process summary above and instructions below.)
All other referrals should be placed as regular orders in OCHIN Epic.
Please pay attention to specific requirements (see below)

E-Consults

E-consults are available at LPCH for many specialties, including Dermatology, Endocrinology, GI, Adolescent Medicine & Adolescent GYN, Psychiatry, and others.
Place e-consult orders directly in SCH Epic, within an Orders-Only encounter, while logged in to LPCH Link.
For Dermatology e-consults, get a photo consent from the family, use Haiku and upload to Stanford Epic.

Before placing a referral - check the following

Patient insurance

Insurance	Referral options
Health Plan of San Mateo (HPSM)	LPCH
Non-county based Medi-cal	LPCH
Anthem Blue Cross (Santa Clara County)	LPCH or SCVMC
Santa Clara Family Health Plan or Valley Health plan	Refer to SCVMC or change to Anthem Blue Cross
Alameda or other county	Referrals are unlikely to go through. Patient needs PCP in the county where they have Medi-cal to make referrals

Out of Network status

If a patient's Santa Clara County Medi-cal is listed as Out of Network, GPCHC has not been registered as the patient's Primary Care Provider (PCP), and referrals will not be processed.

Information/forms for changing PCPs:

Santa Clara Family Health Plan PCP Changes: 1-800-260-2055
Anthem Blue Cross PCP Changes: 1-800-407-4627
Valley Health Plan PCP Changes: 1-888-421-8444

NOTE: Santa Clara patients who change insurance to Anthem are often automatically assigned to a different PCP by default. Referrals to LPCH will not be processed if GPCHC is not listed as the PCP. Please advise patients accordingly, and given them our facility code: XQ2000. The front desk staff can help check what PCP has been assigned.

LPCH Referrals

Referrals to LPCH are ONLY appropriate for patients with Health Plan of San Mateo, Anthem Blue Cross, or state Medi-cal.

LPCH Sleep Medicine or Weight Clinic

Eating Disorders or Gender Clinic

Submit as CERM referrals (see see All other LPCH referrals below)

For Eating Disorders:
- Refer to Child Psychiatry, and mention Eating Disorders clinic in the referral comments
- Complete and fax the EDC referral form and growth charts to 650-497-4246
For Gender Clinic, refer to Endocrinology, and mention Gender Clinic in the referral comments

All other LPCH referrals

SCVMC Referrals

Referrals to SCVMC are appropriate for patients with Santa Clara Famly Health Plan, Valley Health Plan, or Santa Clara County Anthem Blue Cross

SCVMC referrals have a lot of constraints. Click here for information about typical wait times and requirements. (Click on the name of the specialty to see referral guidelines.)

Please make a plan to track and troubleshoot any referrals placed to SCVMC.

See below for specialty-specific details.

SCVMC Dermatology and Orthopedics

SCVMC Dermatology will not accept referrals unless they include photographs

Take a photo using the designated clinic camera (RN desk in ACC)
Include a patient label in the photo to identify the patient
Have the parent/guadian sign a Consent to photograph form
Give the camera and consent to the clinic coordinator to upload to the Gardner referral system

SCVMC Orthopedics generally will not accept referrals unless they include radiographic images.

SCVMC Pediatric Healthy Lifestyles Clinic

PHLC referrals require that patients have labwork to screen for complications & co-morbidities of obesity within a year of referral.

When placing a referral, enter lab results in the comments.
If labs have not been done yet, enter "Labs ordered at LPCH" in the comments. PHLC staff will remind families to have labs done when they call to schedule.

STAT and Urgent referrals

STAT Referral

Gardner Referral Center will process within 24 hours.*

Call Valley on-call specialist.
Enter referral in OCHIN Epic including name of physician who approved referral.
Call Gardner Referral Center to notify that STAT referral was placed.

Urgent Referral

Must be medically indicated. Should not be based on patient request.

Gardner Referral Center will process within 3-7 days.* (VMC will still consider this a ROUTINE referral.)
Does not require MD to MD communication.

Enter referral in OCHIN Epic.
Document one or more of the following reasons for urgent referral status in comments:
1. Serious medical condition that needs prompt follow-up with the specialist.
2. Abnormal report/labs that needs prompt follow up by the specialist.
3. Specialist has requested that the referral be placed in the system before a decision can be made (e.g., e-consult).
Call Gardner Referral Center urgent referrals line (408-272-6348) to notify the team that an urgent referral was placed.