Referral trouble..appt Thursday???

I have been waiting for a month to have my consult which is Thursday the 15th. I come in to work tonight and I have a message on my WORK phone-no call to home phone--stating that I need a referral for the consult appointment. Well, I have MUSC Options and I can self refer to an in-network physician at a higher copay with the same 100% benefits paid after the copay. I do NOT have a referral since I am SELF referring! Of course when I called back she was gone for the day. I left a message for her to please call me ASAP in the morning so if I have to get a referral I have exactly ONE day to get it. I am upset about this--why would I need a referral for this if I can self refer???? Is bariatrics different somehow? Anyone out there with this type of insurance, I would really appreciate your input. I'm hoping she just didn't know much about my policy and has no clue that I can self refer???

Stephanie with any surgeron they need a referral from some form of provider you see. I had a problem getting my Primary Care provider-she wouldn't referr me. So I had my GYN provider and my Gastroligist do it. No sure if this explains it but I know with my insurance I can see anyone I want and its covered but in this case a referral is needed...Good luck your case may be different. I pray it is.

If your insurance requires a referral, they won't pay for the consult without one. Does your insurance require you to go thru their office before any service? If so, you do need to go through them and it doesn't take but one phone call to get a referral. We tell out patient's first thing to check with their insurance company to see if the surgery is a covered benefit and if so, what is the criteria and is a referral needed. Hope this helped a little Deb

I have MUSC Options and I did get a referral from my PCP. I thought that is how it works. I think the self-refferals are only for out-of-network services not in-network. You can call your PCP this morning 1st thing and tell them the problem. I think they can push through referrals. If not, dont sweat it, it will only be postponed a week or two. I had to wait close to a month before my consult, because my PCP office did not tell me I had to fill out the packet, then I could get the referral. I almost thought that someone upstairs did not want me to go through with this. Boy that was wrong. I am sorry you are going through this, but do not lose faith, it will happen. It stinks that they did not call you at home. Sometimes I think MUSC, as much as I love that hospital, Doctors, and staff, does not follow through as well as they should when it comes to appointments. They changed my 1 mth appointment and did not tell me. They relied on that automated message to tell me and I do not live alone. I did not get the message and went to the appointment at the time I thought and Dr. B was not even there. So keep on top of them. Good Luck Julie

UPDATE: Ok--I was stressed for nothing. The office didn't note the change in my insurance and yes, if you have a PPO, then you can self refer to any in or out of network doctor or specialists. I knew that I could self refer but I was thinking that since it is a bariatric procedure that they may want a pcp to have ok'd me first. The appt is still on for tomorrow morning!! I am disappointed in the follow-up though since I did not hear from the office until 12pm!! I asked to be called first thing in the morning since it was very important. I hope my surgery follow up will be handled better than this since I will be seing them often for fills (I'm going for Lap-Band). Thanks to all that replied.

yippie!!! good luck

Good I am glad is for nothing. And as an MUSC Options person that is good information to know. I was not aware, I thought all speciality care had to be referred through your PCP. Thanks for the info. Good luck with the appt. Julie