Question:
Now what?

I have Cigna HMO, with a local gatekeeper, Seaview IPA. My PCP submitted a request for referral to dr Anthone. The gatekeeper has denied the referral, saying Dr. Anthone is not a provider of theirs. Would it be easier to switch to a PCP who is in the same IPA as Dr. Anthone, and get him/her to get a referral, or should I appeal my IPA's decision? Any advise would be appreciated. Ellen    — Ellen B. (posted on June 26, 2000)

June 26, 2000
I don't think switching pcp's is going to help. The surgeon you are trying to see is not part of their network. At least that is how it works in my HMO but I don't have a gatekeeper. Call your IPA and ask what surgeons you can go see.
   — Alison B.