Question:
My PCP will not recommend Dr. Fisher in Las Vegas. Does anyone know why?

I have Cigna HMO so my only choice is Dr. Fisher, but my PCP told me that I would have to choose another PCP if I wanted a referral to Dr. Fisher. I'm stuck between a rock and a hard place. I have read the comments in the DR's section, but need more info on Dr. Fisher to see if he's worth changing my PCP for?????????????? Thanks    — amw1313 (posted on May 29, 2002)

May 29, 2002
With an HMO, if your PCP and a specialist are part of the same medical group (IPA), there shouldn't be a problem with your PCP referring you. I could understand it if Dr. Fisher wasn't part of the same medical group as your PCP, is he? If he isn't, then that could be the problem. If he isn't part of the same medical group, then you would have to find a PCP that's part of Dr. Fisher's group. For instance, if you PCP belongs to Medical Group "A", he can only refer you to a specialist that's also part of Medical Group "A", if Dr. Fisher is part of Medical Group "X", he can't refer you there, only another PCP w/Medical Group "X" can. Now, if your PCP has a good MEDICAL reason for wanting you to Dr. Fisher, that might be an avenue to pursue with CIGNA, but again, it would have to be a good MEDICAL reason. I would see if your PCP can give you more information, specifally why he can't refer you to Dr. Fisher. That's a start! Good luck!
   — Rosario T.

May 29, 2002
I would ask your PCP for specific reasons why he will not refer you, and you should get these IN WRITING. If you belong to Cigna HMO (I do too), you know that you can't get anywhere unless you have a PCP referral. If your PCP won't give you a referral to someone in network, then you will likely either have to change PCPs or change insurance cos. If your doctor is refusing to give you a referral, and you have his reasons IN WRITING, you can appeal to Cigna, telling them your doctor refuses to give you a referral to the only doctor in the network which does WLS. They will likely either let you proceed without the referral or give you some other option.
   — Terissa R.