Will my insurance company know if I see a specialist w/o a referral from my prim!
Question: Will my insurance company know if I see a specialist w/o a referral from my primary care physician!?
I have Pacificare HMO health insurance!. I recently got lab work and my primary physician's nurse said I do not have insulin resistance!. I was diagnosed with it about 8 years ago and I still have the same symptoms, so I think I still have it!. And I want to go to the same doctor I went to who is an endocrinologist!. I am embarassed to ask my PCP for a referral to the endocrinologist b/c they just told me I don't have it and I don't want to bother them!. Can I just go see her, show my insurance card, and get by with it without the official referral!?Www@Answer-Health@Com
Answers:
Don't be embarrassed!. You are not bothering your doctor!. You are paying him!. He works for you!
Tell him you want a second opinion!. This will be a hit to his ego, but that's just tough!. He needs to suck it up!. He works for you! Your job is not to protect his ego!. Tell him that he needs to refer you to an endo for a second opinion!.Www@Answer-Health@Com
Tell him you want a second opinion!. This will be a hit to his ego, but that's just tough!. He needs to suck it up!. He works for you! Your job is not to protect his ego!. Tell him that he needs to refer you to an endo for a second opinion!.Www@Answer-Health@Com
If you want to pay on your own, sure go without a referral!.
If you want the HMO to cover it, you will NEED a referral--even if you seem to get away without one initially--in which case you'll pay in full!.
I don't know what your lab results were or your symptoms are, but ASK your PCP for a referral!. Even if you don't have "insulin resistance" you might need an endocrinologist!.Www@Answer-Health@Com
If you want the HMO to cover it, you will NEED a referral--even if you seem to get away without one initially--in which case you'll pay in full!.
I don't know what your lab results were or your symptoms are, but ASK your PCP for a referral!. Even if you don't have "insulin resistance" you might need an endocrinologist!.Www@Answer-Health@Com
With Pacificare HMO insurance, you do need a referral or authorization to see a specialist, or anyone other than your primary care physician!. My suggestion would be to talk with your primary doctor to explain the concerns of your symptoms!. Even if the lab work showed that you did not have that specific problem, you still have symptoms that concern you!. Speak up and be honest about what you think you need!.Www@Answer-Health@Com
Your insurance will know that and will pester you about it later on!.
Your doctor owes you a duty to refer you for things like that!. You are not "pestering him"!. Doctors take their duty VERY seriously!. Being a doctor isn't like being a plumber or a lawyer or any other job!. We take the oath!. And we mean it!.Www@Answer-Health@Com
Your doctor owes you a duty to refer you for things like that!. You are not "pestering him"!. Doctors take their duty VERY seriously!. Being a doctor isn't like being a plumber or a lawyer or any other job!. We take the oath!. And we mean it!.Www@Answer-Health@Com
Just ask ur PCP!. Just tell them that things are bothering u and u just want a second opinion!. If u sound really concerned about it they will be more than happy to call it over for u!.!.!. And if they give u trouble saying - oh u dont need to get rechecked, Id get a new doc!. plus, yes the ins co will know (i use to deal with insurance billing stuff) So just ask!.!. But if u really not wanting to, u could explain the whole story to ur endo doc and ask if they would get a referral for u!.!. Its just better asking urself, cuz u know why u are asking for the referral and u might end up calling ur doc anyway if they need ur permission!. anyways, good luck :)Www@Answer-Health@Com