Question:
Has anyone experienced this????
With my type of insurance,(Bc/BS) I do not need a referral, but the insurance Co. wants at least a script saying it's ok for me to have surg. My pcp's referral person refuses to write anything for me! She just keeps saying "You don't need a referral" I even had the surgeons office call her in which she was very rude to them. HELP!!! — Chris W. (posted on July 25, 2000)
July 25, 2000
Chris,
I think maybe you are talking to the wrong person at your PCP's office.
You don't need a referral, of that she is correct. What the insurance
company is asking for is CLEARANCE from your PCP. Basically, a letter
stating that you are healthy enough to undergo surgery. Try contacting the
PCP's office again and tell them that you need a medical clearance for
surgery.. see if that helps!
— BethVBG
July 25, 2000
I have BC/BS Federal and my WLS requested a letter of support from my PCP.
I did not need a referral, but the letter was sent along with my packet to
insurance company.Ask for a letter of support. Good Luck. BC/BS paid
great. My surgery with hospital bill was over 35,000.00 and they paid
everything that had to be paid. I was thrilled. Surely thoughts I'd have
to paid several hundred. Good Luck!
— ann A.
July 25, 2000
I have BC/BS Federal and my WLS requested a letter of support from my PCP.
I did not need a referral, but the letter was sent along with my packet to
insurance company.Ask for a letter of support. Good Luck. BC/BS paid
great. My surgery with hospital bill was over 35,000.00 and they paid
everything that had to be paid. I was thrilled. Surely thoughts I'd have
to paid several hundred. Good Luck!
— ann A.
July 25, 2000
I too have BC/BS Federal. I did not need a referral but my WLS wanted one
because I had other insurance companies that would reduce my cost if they
approved also, and he wanted to make sure BC/BS had EVERYTHING necessary to
approve first time around. My PCP refused to write a letter referring me.
I finally had to tell her that as my doctor I wanted her to write a letter
explaining what my medical condition was - that I was obese, that I had
diabetes, that I had arthritis, and that I had breast cancer (estrogen
driven and possibly linked to obesity since obese females put out more
estrogen). I informed her I expected her to communicate this to my WLS
surgeon to ensure continuity/quality of care. I laso told her I could care
less if she referred me, I just wanted the insurance companies to have
SOMETHING from my current PCP (so it wouldn't look like a new one was just
padding my medical record). She was not pleased, but she did send the
letter. She did tell me that she would not, however, refer me for surgery.
I told her that was okay, waited for the letter to get to my doctor, then
fired her and got another PCP who was more than willing to refer me given
my history. She had to go......:-)
— Alicia B.
July 25, 2000
I was told that all my PCP needed to do was write "medically
clear" on a prescription pad and sign it. Of course, this is after,
chest xrays, blood work and ekg.
— Lillian G.
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