Question:
Insurance doesn't require referral...
A friend of mine is in the beginning of the whole referral process. Her insurance does not require a referral. But the surgeon wants one. Her PCP isn't in favor of WLS, and is stalling her. Since her insurance doesn't require the referral, why is the surgeon adamant on getting one? Is that right? What should she do? — Cheri M. (posted on April 18, 2002)
April 18, 2002
Hi there, my insurance also doesn't require a referral. I am going to a
surgeon out of state and he didn't insist on a referral either. He did
however want me to get a complete physical and history done before coming
out to see him. Perhaps the surgeon wants your friend to get a referral so
that he knows she meets the general criterea for WLS. It's hard to tell.
Maybe she can just got to another doctor besides her PCP for a visit and
see if she can get a referral for WLS that way. She also might want to
find a new PCP all together. I just did that myself. Best of luck!
— [Deactivated Member]
April 22, 2002
Hi...With my insurance, I also do not need to have a referral. I actually
went to see 2 different surgeons before deciding on the one that I chose
and neither of them wanted a referral or asked for one. If her PCP is not
in favor of WLS and is not supportive, she really should look for another
PCP. Not having the support of your doctor does not help at all. I would
suggest she find another doctor, get a full physical and then ask him/her
for a referral. If they are in favor of the surgery and know of all the
weight loss attempts your friend has tried, I am sure they will not have a
problem with giving a referral.
— Giovanna G.
April 24, 2002
I have just recently started this process and work for my insurance
company. I am on the PPO plan and do not require a referral but my surgeon
does. I asked his office staff why this was if the insurance does not
require it and he said they want to make sure you have someone good to
follow up with and someone who is supportive of the surgery. You do follow
up with the surgeon at first but not forever. I called my PCP office (which
I had only been to twice prior to this and nothing related to my weight)
and asked the office supervisor to check with the doctor to find out if she
was supportive of this procedure. I didn't want to waist my time or money
if she didn't agree. To my suprise she is VERY supportive of this and
actually one of the girls in her office has had gastric bypass. Needless to
say she gave me my referral and I have had my bloodwork done and have my
gallbladder ultrasound on Friday. BETTER TO FIND A SUPPORTIVE DOCTOR NOW
THEN WHEN YOU ARE HAVING A PROBLEM AND NEED HELP.
— Heather ..
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