Question:
I just can't get my refereral process/to the insurance co. HELP!!

Hi! everyone it's me again! I had problems just getting a referral from my doctor because he thinks I need will-power(one of those "BUTTS"!) Now, the staff have not process my referral to the insurance co. I demanded a referral in july 02, it is sept. 02 and the ins. co still has not receive the weight management referral form to reveiw. I also spoke with the manager at my PCP med. ctr. -- still no help. Are there any organizations for patients who have problems/complaints with their Dr./med. ctr. PLEASE HELP ME!!! (Balto. MD)    — JUNE P. (posted on September 12, 2002)

September 12, 2002
Sounds like it's time to change doctors. Find a new one, and tell the old one why you're leaving. Stick up for yourself!
   — Angie M.

September 12, 2002
I agree with Angie, it's time to find a doctor who really cares. His loss.
   — Sarah K.

September 12, 2002
I hate to tell anyone but I use to work in Manage Care and felt guilty all the time. You see your insurance hates to pay for this surgery...well your medical group because they are partially responsible for the bill, not your insurance. It depends on the contracts. So the Dr.s kind of get in trouble many times from the owners of the medical group for writing the referrals.. My advice to you is to complain to your insurance company ASAP. The medical group is not the one to complain to. Also, go to your DR.'s get your referral and hand carry it yourself to managed care dept. Or you can change PCP's and start all over again. HMO"s are really tricky. I no longer work in manage care because I felt really bad for some patients being denied. We always denied WLS the first time around. Our owner was a donkey if you know what I mean. I hope this helped a little. Good Luck. Happiness....Maryellen
   — Maryellen C.

September 12, 2002
Hi June. If this PCP isn't cooperating now, at the beginning of your weight loss journey, they aren't likely to be much help later either. PCPs get cash incentives by keeping their HMO patient's referrals to a minimum. Its a sucky system thats best used for very healthy people that rarely see a doctor at all. If I were you, I'd would change PCPs immediately while your only time lost is the consult with PCP at the beginning of your journey.
   — thumpiez