Question:
Any problems with claim payment for mandatory visits to nutritionist & psych visit?
My insurance carrier is BC/BS State of Maryland PPO. The surgery was approved with the knowledge that I am required to see a nutritionist and psychologist prior to surgery. The nutritionist requires a referral from my primary care physician, even though it is not an insurance requirement. My pcp is refusing to do the referral based on a visit to a nutritionist is not covered unless I have diabetes. I have a call into my BC/BS account manager for clarification. At this point I don't know if my pcp is mistaken, or it really is not covered. Has anyone had this issue come up with BC/BS State of Maryland PPO? — Kathy M. (posted on June 7, 2002)
June 7, 2002
Hi,
I have BB/BS too... and they did not pay for the psych
or dietician in spite of the fact the the surgeon would
not book me until I did, meaning it was also mandatory
for me. I paid myself...It was not all that much in the
long run. By the way, prior to meeting with them perhaps
you could work out a payment plan so it does not cause
financial hardship for you. I know all the bills that
I have subsequent to the surgery (about 2,000. which were
not covered due to stop loss)so I have written all my providers letters and
made payment arrangements and they are all fine with that.
Best wishes to you. I hope this helped.
— Ann B.
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