Question:
Any problems with claim payment for mandatory visits to nutritionist & psych visit?

My insurance carrier is BC/BS State of Maryland PPO. The surgery was approved with the knowledge that I am required to see a nutritionist and psychologist prior to surgery. The nutritionist requires a referral from my primary care physician, even though it is not an insurance requirement. My pcp is refusing to do the referral based on a visit to a nutritionist is not covered unless I have diabetes. I have a call into my BC/BS account manager for clarification. At this point I don't know if my pcp is mistaken, or it really is not covered. Has anyone had this issue come up with BC/BS State of Maryland PPO?    — Kathy M. (posted on June 7, 2002)

June 7, 2002
Hi, I have BB/BS too... and they did not pay for the psych or dietician in spite of the fact the the surgeon would not book me until I did, meaning it was also mandatory for me. I paid myself...It was not all that much in the long run. By the way, prior to meeting with them perhaps you could work out a payment plan so it does not cause financial hardship for you. I know all the bills that I have subsequent to the surgery (about 2,000. which were not covered due to stop loss)so I have written all my providers letters and made payment arrangements and they are all fine with that. Best wishes to you. I hope this helped.
   — Ann B.