Question:
PCP Referral Beofre Anything???....
Hi Everyone! I have my evaluation for gastric by pass surgery in August But before I go Should I have a PCP Referral or just make the initial consultation on my own?? Please anyone.... Respond....I would greatly appreciate it!! Vicki — Vicki R. (posted on June 22, 2002)
June 22, 2002
Vicki,
It depends on your insurance. If the surgeon charges for the initial
consult, and your insurance company requires a referral, then I would
definately get one.
— maryburton
June 22, 2002
I never had a PCP referal. As a matter of fact, my PCP was so against the
surgery! So I researched the doctors in my area for this type of surgery
(rny) and made my own appointment and the surgeon took care of everything
else.
— Rebecca G.
June 22, 2002
Vicki,
My insurance company does not require that I have a referral
to see a specialist. Therefore, I did my research and made the
appointment on my own. My PCP doesn't even know that I am
having it done, although he will find out next week when I
see him for my pre-op physical-LOL! Best of luck with
your process!
— Heather N.
June 22, 2002
Personally, I would ask your PCP to write you a letter of medical
necessity. This HAS to count when your insurance is looking at your
request. I mean, if a doctor, in their network says you need surgery, who
are they to question that? It certainly couldn't hurt, and may very well
mean the difference between approval and denial.
— Greg P.
June 22, 2002
I would get a referral before I did anything. That way you'll be sure to
be covered by your insurance. Like they always say, better safe then
sorry.
— Amy C.
June 23, 2002
Hi Vicki,
Yes, Contact your PCP for a referral. Let them know you have sought out a
surgeon and would like to begin the process. Also tell your PCP about your
last appointment with the GYN. The more imformation available to your
insurance. You stand a better change of getting approval.
Good Luck.
Aynikaye
— Aynikaye
June 23, 2002
I saw in your profile that you have medicaid - and I do believe that in
most cases they do require a pcp referral for any non-emergency surgeries.
Ask your caseworker though to be sure. They're usually pretty helpful.
— [Deactivated Member]
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