Insurance and Lab and PCP questions?
After reading posts about PCP's and lab draws and insurance I am wondering a couple of things:
1) How will I know what labs Tricare will pay for?
2) Is it up to my PCP's discretion as to which labs she asks for? (meaning....since Dr. Martin is doing my surgery in WA......my PCP here will have to do all my bi-annual follow-up.......is it up to "her discression" what labs or "if" she will follow the vitalady list I will give her? If she won't order all of that......I assume I change PCP's? I guess I am saying do most of them "order" what you ask for.......or can they refuse?
3) She is a PA that works under her "brother" the D.O. I've never seen him. I am not a very "sick" person and usually only see her for the occasional "stuffy nose"...so all in all I've seen her like 5x in 4 years..........would you suggest I "start"over with a more "advanced" PCP?
4) I haven't seen her since Dr. Martin approved me for surgery....I did print out Diana's letter and was going to share it with her the next time I needed to see her for something....to give her a heads up........but now I am wondering if maybe I should find a more experienced doc?
what are your thoughts?
I did see Dr. Stewart here in Texas....but remember Tricare won't pay for DS, so I can't use him. I doubt that he would do my follow-up? Actually, as I type this.....I doubt Tricare would "pay" for him to do my "follow-up" as he is a surgeon and NOT a PCP. Hmmm
I guess I just feel like normal PCP's are gonna be clueless as how to handle me......therefore.....the need for me to be proactive....as was previously posted by so many vets.....and take Diana's letter. I am just wondering if my PCP is the "best choice"? PCP's aren't all created equal I don't think?
1) How will I know what labs Tricare will pay for?
2) Is it up to my PCP's discretion as to which labs she asks for? (meaning....since Dr. Martin is doing my surgery in WA......my PCP here will have to do all my bi-annual follow-up.......is it up to "her discression" what labs or "if" she will follow the vitalady list I will give her? If she won't order all of that......I assume I change PCP's? I guess I am saying do most of them "order" what you ask for.......or can they refuse?
3) She is a PA that works under her "brother" the D.O. I've never seen him. I am not a very "sick" person and usually only see her for the occasional "stuffy nose"...so all in all I've seen her like 5x in 4 years..........would you suggest I "start"over with a more "advanced" PCP?
4) I haven't seen her since Dr. Martin approved me for surgery....I did print out Diana's letter and was going to share it with her the next time I needed to see her for something....to give her a heads up........but now I am wondering if maybe I should find a more experienced doc?
what are your thoughts?
I did see Dr. Stewart here in Texas....but remember Tricare won't pay for DS, so I can't use him. I doubt that he would do my follow-up? Actually, as I type this.....I doubt Tricare would "pay" for him to do my "follow-up" as he is a surgeon and NOT a PCP. Hmmm
I guess I just feel like normal PCP's are gonna be clueless as how to handle me......therefore.....the need for me to be proactive....as was previously posted by so many vets.....and take Diana's letter. I am just wondering if my PCP is the "best choice"? PCP's aren't all created equal I don't think?
PCPs definitely aren't created equal. I love my PCP. Such a cool dude, open to my ideas, and does pretty much whatever I want...lol
As far as labs that tricare will cover...I don't know. I'd hope they'd cover all of them with the correct coding. I'd assume you could call and ask what labs are covered under the diagnosis code of surgical/intestinal malabsorption and how often you can have them done. Maybe others with tricare will chime in with their experience. This will, of course, be open to whatever lab copays and coinsurance you have.
Technically, yes, it's up to your PCP's discretion what she will order. She doesn't HAVE to order anything. But she should. If my PCP were arguing with me about this stuff, I would get another PCP. I have absolutely nothing against PAs or NPs versus MDs. Experience is experience. As long as they can get me the care I need and are respectful and nice...it's all gravy. You may, in the future, need more advanced care from a specialist, though. I have specialists out the wazoo. Some specialists that DSers may need in the future include an endocrinologist and hematologist. I also have a gastroenterologist.
I'm not sure that Dr. Stewart would do your follow up, or whether you even need him to.
As far as labs that tricare will cover...I don't know. I'd hope they'd cover all of them with the correct coding. I'd assume you could call and ask what labs are covered under the diagnosis code of surgical/intestinal malabsorption and how often you can have them done. Maybe others with tricare will chime in with their experience. This will, of course, be open to whatever lab copays and coinsurance you have.
Technically, yes, it's up to your PCP's discretion what she will order. She doesn't HAVE to order anything. But she should. If my PCP were arguing with me about this stuff, I would get another PCP. I have absolutely nothing against PAs or NPs versus MDs. Experience is experience. As long as they can get me the care I need and are respectful and nice...it's all gravy. You may, in the future, need more advanced care from a specialist, though. I have specialists out the wazoo. Some specialists that DSers may need in the future include an endocrinologist and hematologist. I also have a gastroenterologist.
I'm not sure that Dr. Stewart would do your follow up, or whether you even need him to.
5'9.5" | HW: 368 | SW: 353 | CW: 155 +/- 5 lbs | Angel to 
Yup! Kayla's answer is A-OK!
I also love my PCP and he basically does whatever I tell him to do as well! :)
I say you make an appointment with your current doc and have a frank conversation about it all.....what labs you will need, how often and why and see if she's willing to work with you. You won't know until you ask. If she's not, then you can start your search for one who is.
I also love my PCP and he basically does whatever I tell him to do as well! :)
I say you make an appointment with your current doc and have a frank conversation about it all.....what labs you will need, how often and why and see if she's willing to work with you. You won't know until you ask. If she's not, then you can start your search for one who is.
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