Question:
Insurance doesn't require referral...

A friend of mine is in the beginning of the whole referral process. Her insurance does not require a referral. But the surgeon wants one. Her PCP isn't in favor of WLS, and is stalling her. Since her insurance doesn't require the referral, why is the surgeon adamant on getting one? Is that right? What should she do?    — Cheri M. (posted on April 18, 2002)

April 18, 2002
Hi there, my insurance also doesn't require a referral. I am going to a surgeon out of state and he didn't insist on a referral either. He did however want me to get a complete physical and history done before coming out to see him. Perhaps the surgeon wants your friend to get a referral so that he knows she meets the general criterea for WLS. It's hard to tell. Maybe she can just got to another doctor besides her PCP for a visit and see if she can get a referral for WLS that way. She also might want to find a new PCP all together. I just did that myself. Best of luck!
   — [Deactivated Member]

April 22, 2002
Hi...With my insurance, I also do not need to have a referral. I actually went to see 2 different surgeons before deciding on the one that I chose and neither of them wanted a referral or asked for one. If her PCP is not in favor of WLS and is not supportive, she really should look for another PCP. Not having the support of your doctor does not help at all. I would suggest she find another doctor, get a full physical and then ask him/her for a referral. If they are in favor of the surgery and know of all the weight loss attempts your friend has tried, I am sure they will not have a problem with giving a referral.
   — Giovanna G.

April 24, 2002
I have just recently started this process and work for my insurance company. I am on the PPO plan and do not require a referral but my surgeon does. I asked his office staff why this was if the insurance does not require it and he said they want to make sure you have someone good to follow up with and someone who is supportive of the surgery. You do follow up with the surgeon at first but not forever. I called my PCP office (which I had only been to twice prior to this and nothing related to my weight) and asked the office supervisor to check with the doctor to find out if she was supportive of this procedure. I didn't want to waist my time or money if she didn't agree. To my suprise she is VERY supportive of this and actually one of the girls in her office has had gastric bypass. Needless to say she gave me my referral and I have had my bloodwork done and have my gallbladder ultrasound on Friday. BETTER TO FIND A SUPPORTIVE DOCTOR NOW THEN WHEN YOU ARE HAVING A PROBLEM AND NEED HELP.
   — Heather ..