Question:
Anyone choose to have primary DR. follow post op and not surgeon?

I have decided to have my primary physician follow me post op. I have some issues with my surgeon and don't care to go back to him. My primary gave me the referral I needed for the surgery and has a complete record of my surgery and complications. I am now 10 months post op and had my labs taken for the first time last month (all is well). My problem is the insurance company (the one who paid for my surgery) is refusing coverage for the labs. I have been on the phone with the insurance co./dr's office/ and lab (who is in network btw) and am getting NO WHERE. Has anyone else had problems with getting post op needs covered when using their primary instead of surgeon? What did you do? I'm ready to call the insurance commisioner...it's not like any of these people didn't realize there is long term care needed for patients of this surgery? Any input would be appreciated. Thanks. -Kim open RNY 7/17 -109    — KimBo36 (posted on May 16, 2002)

May 16, 2002
Hi, Kim - My primary md has done my labwork every 2 mos since surgery. My surgeon doesn't do that follow up. I can't imaging why your insurance co. is giving your grief over this. Good luck!
   — Jean K.

May 16, 2002
Tell your doctor to bill the for the labwork with the diagnosis code for malnutrition and the insurance company should pay for it. He will need to give the lab this diagnosis code too. It has nothing to do with the insurance company. It has to do with the codes that the doctor provides the insurance company. If he uses a code that indicates "routine" bloodwork (rather then then REAL reason you had it done) that's why the insurance company isn't paying the claim. Good luck.
   — Patty H.