Question:
Does BCBS Fed (Basic) require PCP referral to surgeon?

I was just wondering if anyone knew if I *had* to get a referral to a WLS surgeon or if I could just skip the PCP visit and make an appt w/the surgeon? I don't have an established PCP and don't want to go through finding out whether they are supportive of WLS or not... if I don't have to, that is. Thanks! Christina    — Christina Z. (posted on January 22, 2003)

January 22, 2003
I have BCBS Fed and did not require a referral from a PCP. In fact, I told my PCP after I had a surgery date. Fortunately I have a great PCP who has been extremely supportive and also has other WLS patients too!
   — Cindy R.

January 22, 2003
I have the same ins. and no the don't. You might also like to know that they don't pre approve this surgery. Just have to be MO and 100 lbs. overweight. After I did the few things my surgeon requires for surgery they scheduled my surgery and then called my ins. I believe the call is for the hospital stay. Good Luck. Hopefully someone at the surgeons office will be a great help to you with this.
   — Kim N.

January 22, 2003
I had federal BC/BS basic (now I have standard) and I didn't even have a PCP when I went to my WL surgeon for a consult. I had just switched from Kaiser as I didn't think they were taking my health seriously. Didn't need a referral when I went to a see a plastic surgeon either. But, just to be sure, you should check your benefits plan.
   — Lisa N M.

January 22, 2003
You do not need a referral to go for WLS or to a plastic surgeon. You do need to have a predetermination however, before you have the actual procedure done. I was approved for RNY within days of it being submitted. I am now waiting for a decision on the reconstructive surgery.
   — jan M.

January 22, 2003
You do not need a referral to go for WLS or to a plastic surgeon. You do need to have a predetermination however, before you have the actual procedure done. I was approved for RNY within days of it being submitted. I am now waiting for a decision on the reconstructive surgery.
   — jan M.

January 22, 2003
You do not need a referral to go for WLS or to a plastic surgeon. You do need to have a predetermination however, before you have the actual procedure done. I was approved for RNY within days of it being submitted. I am now waiting for a decision on the reconstructive surgery.
   — jan M.

January 22, 2003
You do not need a referral to go for WLS or to a plastic surgeon. You do need to have a predetermination however, before you have the actual procedure done. I was approved for RNY within days of it being submitted. I am now waiting for a decision on the reconstructive surgery.
   — jan M.