Got my referral

[Lov3ly773 13]

I finally got my referral, but the bariatric coordinator tells me that I can't start the process unless I've been with my pcp for at least a year? So I contacted my insurance BCBS of Illinois ***...and they told me, it doesn't matter the time frame to receive a referral.

My guess is that, the surgical center has their own requirements... one being that you have to be with your pcp for at least 1 year. Well I have the referral and at least I know that my pcp is weight loss surgery friendly.

I'm going to talk to the coordinator again, because she also said that because I have ***, they require that too... which is not true.

What do you think guys???

[1gorgeousgodzilla 192]

I believe you are right and the requirements of your surgical center and insurance company may vary. I initally dealt with a surgical center that required me to use this particular psychiatrist for psych evaluations. No one else. However, he only did them two days a week. Same thing with the sleep study people. At that rate, they could only see me two to three months later. So I consulted with a different facility, and they just wanted the evaluation wtih a licensed person in my area.

If I had remained with the first place, I would have had my sleep consultation (not the study) at the end of July and likely would have just now had my study done. My appointment with "their" psych guy would have been later this month. Instead, I'm nine days away from having my SURGERY . I don't know where you live, but if they insist on that one year rule, you may want to check with other facilities in your area. Just sayin. Good luck to you.

[ribearty 544]

Sometimes also the surgery doctor has a particular doctor they use, especially the psychiatrist or psychologist, because that person is very familiar with how to write the report to help get approval from the insurance company the first time. I know with my insurance, you are required to meet with a person who is familiar with the bariatric surgery process. If the person you see is not, they can deny you on that reason alone.

It is a bonus that your PCP is weight loss surgery friendly. Mine is also. I have been seeing him for a long time almost 20 years, but he is in management at the hospital and sees patients for a few hours a week. I was worried about getting sign off since the doctor I saw was in his group and had never seen me, but after speaking and an exam he is willing to sign off on my surgery.

[Lov3ly773 13]

I believe you are right and the requirements of your surgical center and insurance company may vary. I initally dealt with a surgical center that required me to use this particular psychiatrist for psych evaluations. No one else. However' date=' he only did them two days a week. Same thing with the sleep study people. At that rate, they could only see me two to three months later. So I consulted with a different facility, and they just wanted the evaluation wtih a licensed person in my area.

If I had remained with the first place, I would have had my sleep consultation (not the study) at the end of July and likely would have just now had my study done. My appointment with "their" psych guy would have been later this month. Instead, I'm nine days away from having my SURGERY . I don't know where you live, but if they insist on that one year rule, you may want to check with other facilities in your area. Just sayin. Good luck to you.[/quote']

Yeah, I think that's the surgical center that is telling that I have to be with my pcp for one year, I may have to just find a different facility. I'm on the westside of Chicago.

I was thinking, that's crazy to say you have to be with your pcp for a year... what about emergency procedures lmao.

I'm going to research other facilities, if they are going to stick to this year business. I'll just have to get another referral.