Question:
Can I still see my surgeon with no referral, and later get reimbursed?

Hi. I'm seeing a new pcp for the first time this Friday. I have my surgical consult next Friday. If I don't get the referral I need, what should I do? I've waited to get in for the consult...I sure don't want to cancel it. But I can't afford the $150 appt. myself. Maybe see another pcp before next Fri.? I'm hoping I'll get the referral, but I like to plan ahead and have a backup plan ready. Did any of you get denied an initial referral but then went on to have the surgery? How'd you go about it?    — Linda J. (posted on August 30, 2000)

August 30, 2000
What kind of insurance do you have. HMOs are very strict when it comes to referrals. Just to be safe, it would be wise to call the customer service number on your insurance plan and ask. If they allow it, make sure you get the name of the person you spoke with so there are no "surprises" later. good luck!
   — cheryl W.

August 30, 2000
What kind of insurance do you have. HMOs are very strict when it comes to referrals. Just to be safe, it would be wise to call the customer service number on your insurance plan and ask. If they allow it, make sure you get the name of the person you spoke with so there are no "surprises" later. good luck!
   — cheryl W.

August 30, 2000
Dear Linda, Remember when I asked who you had for your insurance company? What type of plan is it? This is the same issue I have because I have an HMO. Not to be a bummer either but some insurances only let you change pcp's on the first of the month. If things do not go well for you on Friday you may wish to ask the membership in your area who they have dealt with. I know there are several in the Janesville, WI area. Here is hoping things go well with this pcp Friday. Hugs.
   — JennyLynn A.

August 30, 2000
It's not always true that you don't need a referral for PPO and POS. I have United Healthcare Select POS. I needed a referral from my PCP. But, unlike a HMO which almost always wants a written one, all my PCP had to do was call my surgeon's office and give the referral over the phone. Good luck.
   — Maxine E.

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