When getting approval?

(deactivated member)
on 6/8/07 3:51 am - Bowie, MD
I have been reading some post's and im kind of confused..In your opinion is it better to go to your PCP and have them refer you for the surgery? or Is it better to go to a surgeon and have them recommend the surgery and go back to your PCP and get a letter of approval? If you understand what im asking and would like to add more on that may be helpful information for that would be great. Thanks alot everyone!!!
JCANAPP
on 6/8/07 4:05 am - MD
IF YOU KNOW WHAT SURGEON YOU WANT I WOULD GO THERE FIRST. MOST PCP ARE OKAY WITH THAT UNLESS YOUR INSURANCE REQUIRES PAPER REFERRALS THEN YOU HAVE TO GO THERE FIRST
rood2tone
on 6/8/07 4:19 am - MD
If you have an HMO plan, or another type of plan that requires referrals, I would suggest going to your PCP first to get the referral.  Otherwise, your visit might not be covered by your insurance to see the surgeon... and your surgeon might not even see you without that referral in the first place. Good luck!
trashbomb
on 6/8/07 8:59 am - Buckeystown, MD

Well my insurance didn't require that I have a referal before seeing a bariatric surgeon.  However, I knew little about the surgery and sought the advice of my PCP before hand.  She gave me the name of two surgeons she suggested and from there I contacted my surgeon.  His policy, howevr, was that I have a written referral before consult so I called my PCP to request the letter to fax over to my surgeron. So, if your insurance doesn't require a referall your surgeon may.  Too, your surgeon will likely want medical records from your PCP so I think it would behoove you to start with your PCP.  Get what you need in advance so that when either the Surgeon or the Insurance agency ask for it you have it on hand to fax to them to expedite the process. BTW I knew about my approval before my surgeon because I called United Healthcare everyday to check the status.  They told me of the approval before they sent it to the Surgeon :-)

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