Self-Referral for consult - BlueShield of Ca Acess +HMO Federal Employee

Hi, I just wanted to know if anyone with this insurance has used the self-referral for a consult with the Surgeon? I called the insurance and they said that I could self-refer instead of going thur the Medical group to get the consult, and that the Surgeon can request the authorization for surgery. Does this sound right to anyone? My PCP put in my referral to the Meidcail Group and now its in review. i just want a backup plan if it falls thur. Should I just self-refer to the Surgeon and work that?  thanks for any info you can give me.


Lori

what I did was call the insurance co and ask them which surgeons were part of the network in my area.  Than I checked them out and made my decision.  Once I had all my testing done my surgeon sent in the request for approval.

Hi, Thanks for the info- Do you have the same insurnace as me.  Blue Shield of Ca Access + HMO?

Lori

I have BCBS of Ca also Fed employee.  I could have self referred as well.

Hi, I have BC of California (not sure what ou mean by + HMO...gues I don't have that piece)....but anyway,do have BC of Caifornia.

i self referred.  DIdnt' need a PCP to refer me or anthing because mine I guess is considered a PPO...so I just need to make sure they accepted BC of CA and after all the paperwork was completed, I got a consult with the surgeon.

hope that helps.

Hi,

With the BC of CA - PPO - how much was your out of pocket to pay for the surgery, I may just change my insurance at the end of the year to a PPO so I dont need to get referred.

Lori

Have BCBS PPO and paid a TOTAL of 250.00 out of pocket.Fought the HMO people for over a year finally switched to PPO and had  date within 6 weeks

I have BCBS PERS HMO.  I was referred to a surgeon by my PCP and had no problems whatsoever with the approval process.  My out of pocket for the surgery was 0.00 - not even a co-pay for that.

Cathy C.

I have the BS HMO + Access Plus.  I did mine through my PCP but changed medical groups to get the surgeon I wanted. I paid nothing but $5 office visit copays! They even covered my psych evaluation under Pacificare Behavioral Health 100%!