Self pay but hoping my pcp will help with lab work so insurance will pay some

[cumbie76 4]

My name is Alyssa and I am brand new to this forum. I am self pay and having gastric sleeve surgury some time in July. I am needing to get my pre-opt lab work done and have bcbs. My sugeon told me I could take the lab request to my PCP and he could order the labs through him, thus being able for the lab work to be covered by my insurance (he has also put reasons for labwork needed as sleep apnea, GERD, incontinance, joint pain, etc.). My pcp is kind of an old fart, and I am uncertain he will even approve of me doing the surgery (keep in mind I am never sick, never use my pcp, and he has only seen me probably 3 times in the past 4 years I have been on my husbands insurance.). My question is, if I go to get the labwork done on my own, not with my pcp, will insurance pay for any of it? And also, can my PCP out right refuse to order the labs for me?

[ChrisBthin 44]

Why are you self pay if you have bcbs?

[ChrisBthin 44]

If your insurance doesnt pay for your. find a lab called Bio reference Laboratories they can give cash paying customers Discount Cards up to 70%.

[Snufflegus 80]

I have bcbs and am self pay as well - I didn't have to go to my pcp I took my surgeons orders to places that would accept a dr. Order as well as my insurance. I only had to pay the co-pay or deductible at each one. I don't know if you know but being self pay, keep all of your receipts and you should be able to write it off on your taxes.

Not all policies of BCBS cover WLS. I work for a small company and am glad we have insurance but it WLS was an opt in or out for the business and me being the only person who would consider it wasn't worth it for the company to pay the crazy amount to opt in.

[Ms.AntiBand 2,984]

I'm self pay and my insurance pays for my labs and any after care. My PCP is great that way though. As long as your PCP never makes a reference regarding your wls then your insurance should pay. But normally th PCP has to note the reason for the labs. My PCP asks me specific questions that will lead me to answer in ways that labs are called for.

I pay $700 a month in insurance premiums ( plus employers pays in addition to that) with an exclusion for ANY wls ..even complications. So, my PCP knows my situation and works it out for me.

[cumbie76 4]

@Chrisbthin- BCBS/Blulincs of Oklahoma will not pay for gastric surgery.

[cumbie76 4]

Thank you all for the tips!

[Heyher 581]

I was self pay and my insurance paid for the pathology fee for my stomach after surgery. They paid for all my blood work. They paid for my cpap machine. They paid for my O2 when I got home from the hospital. And I got a letter of denial saying they wouldn't pay for ANYTHING related to my surgery. Heck the orders came from my bariatric surgeon. :-)

I'm not questioning it. I'm staying quiet and saying nothing. After all the crap they put me through, I figure its the least they could do.