Smoking Madddddd

I was excited today when I get home from work to find a letter from my insurance company approving my surgery. I have been going thru this process for 5 months now and I'm so ready to be on the losers bench. However, my surgery has been denied due to not be "authorized" by my primary care physician. Really!!!!!

I belong to a doctors office with a group of doctors and you can see any of them and not just your "primary care physician". My surgery date is scheduled for Jan. 19th and I have no clue if this can be resolved by then and of course, I can't contact the insurance company until tomorrow. Pesky HMO's!!!!

Is this common? Is it easy to get resolved? Is this an error on the part of the hospital's insurance professional? I don't even know where to begin and I would be disappointed if my surgery is prolonged and rescheduled because of this insignificant need for authorization from a primary care physician that I have never seen in 10 years.

Seems like your insurance company requires "referrals" to specialists - many do.  If you don't have a primary care doctor, get one, and make an appointment ASAP.  I can't imagine you'd have to go through the process again, but apparently they need that magic "referral" - which I'm sure your PCP will give you once you explain the situation.  (Are you saying you haven't seen any of the doctors in the practice group for over 10 years?)

I've seen many doctors within the practice over the years, just not my assigned doctor. I did have a referral to the bariatric center that's doing the surgery but it wasn't the "primary doctor" that did the referral and that may be the issue. I will be in the doctors first thing tomorrow to get this resolved and I'm sending an email tonite.

Sounds like it should be an "easy fix" -- I've got my fingers crossed for you.

Maybe they need a letter of medical clearance by your pcp.  I needed one too.  The surgeon had me do the tests and blood work and had a copy of results sent till my pcp.  Then my pcp had me schedule an appointment, checked my vitals, filed out a medical history form and signed s document that says I'm healthy enough for surgery.  This might be what they're looking for from you.

They also need to know that the primary will take care of your aftercare. I needed a letter from mine saying he would.