Question:
My Insurance tells me that I DO NOT need a referral from my PCP to see a surgeon...
Has anyone ever heard of this?? I talked to my Surgeon's office and they said to get one just in case some people goofed at the insurance company. Problem is, is that I have spoken to 6 different people there, and they each tell me that I DON'T need one. I went to my PCP 'just in case' and haven't heard back from him, so I called the Insurance again, to find out... Turned out he did send in a referral, but they discounted it because I 'don't need one'. Should I just go ahead with my scheduled appt. with the surgeon (in 10 days) without further thought of the referral? Practically everyone I talk to say that their Insurance company NEEDS the referral FIRST. Thanks for your input, I am literally SCREAMING inside!! --Annie — Annie R. (posted on April 20, 2001)
April 20, 2001
I didn't need a referal either. I wouldn't worry about it, Just be
thankful that you have on less hurdle to jump. good luck.
— Lisa B.
April 20, 2001
I've had 3 insurances over the years. None required a referral. Depends on
the TYPE of plan you have. However, I might need a referral for another
type of procedure and just haven't come across it yet.
— vitalady
April 20, 2001
I didn't have to have a referral from my pcp, thank God because
he would not give me nor any of his patients one for this
type of surgery. So I wrote a four page letter to my Ins. co.
Aetna PPO and was approved within two weeks. No med records
or anything, just my surgeons request at BTC and my letter
and shazaaaam :) I am thrilled and now just waiting on my
surgery date... impatiently waiting I must add :) Good luck!
Renee Donalson
— Renee D.
April 20, 2001
Annie, I did not need a referral to a surgeon, I went to my consult before
I even told my PCP that I was thinking about surgery. As a matter of fact I
had an approval for surgery and was a week away from the date before I told
my PCP, Now this kind of pissed her off, but the deal is that some ins.
companies don't require you to go through your PCP. I can't say the way i
handled the whole thing was a good way, but I was too nervous to tell her
before I knew it would happen. I wish you the BEST OF LUCK!!! KH
— blank first name B.
April 20, 2001
Annie: I didn't need one for blue cross ppo. I wish my PCP was mad at me
for not telling him as Kate's doctor was. That means her's cares about
her. Mine told me that he had a patient that really needed the operation
because he was 400 pounds. He worked 3 jobs and didn't have insurance with
any of them. Am I suppose to feel bad or guilty? I'm at the lower end of
the BMI scale (41ish) but I still qualify and I don't feel guilty or that I
don't need this operation. I think next time you should believe your
insurance. :o) Good luck with the process and ultimately your surgery. S
— sherry hedgecock
April 20, 2001
At the time of my surgery I had keystone . I did need a referral from my
PCP. With my new ins. Unitedhealth care I would not need one as long as the
surgeon is in my network. To look for plastic surgeons in network I go to
the unitedhealth care website.This seemed odd at first to me , but my first
plastics appt was covered.
— Rose A.
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