Patient Referral

SIU HealthCare has made it easy for you to request service for your patients.

Using either the printable form or the online form, you may request a referral or consultation. Providers and their staff now have three options to submit a request. Call 217-545-8000 or toll free at 800-342-5748 (800-DIAL-SIU) and speak to a representative of our Referral or Consultation Service.

Download a printable form and fax the completed form to us at 217-545-1884. We value our relationship with you, your patients, and your office staff. We work hard to keep you informed of your patients' care by providing reports, from diagnosis to treatment and follow-up. Our goal is to provide you with prompt service and communication for the patients that you send to us.


HMO and PPO patients are expected to obtain a referral for the visit (if required by their plan) and to pay the co-payment specified by the plan at the time of service. Please have your patient familiarize themselves with their specific coverage to understand their payment obligation. They should contact their insurance company to determine their plan's specific requirements and coverage options.


SIU HealthCare participates with the state Medicaid programs of Illinois and Missouri. If your patient is from one of these states and has out-of-state prior authorization restrictions, the patient should contact the appropriate people to complete these requirements. Except in emergency situations, SIU HealthCare will not provide care to Medicaid patients from other states unless arrangements are made in advance to fully pay billed charges. Medicaid patients are required to bring their current Medical Assistance card. If their plan requires a co-payment, it will be due at the time of service. If the patient does not have your card, we may not be able to verify plan eligibility and the patient will be considered self-paying.

Patient Follow-Up

SIU HealthCare will provide a summary of diagnostic reports, treatments and follow-up care to the you, the provider.