F#*%ING REFERRALS!

[mr.sean 60]

I started exploring bariatric surgery in October and it's now it's almost April, and I'm only about halfway through the pre-surgery process. It would be easy to blame this on the hoops my insurance company is making me jump through, but the real culprit here is my PCP. Or my PCP's office. They are so terrible with referrals. And with my insurance (Tufts), you can't sneeze without a referral, or you'll be charged full price for it.

For example, I'll call my PCP's office to tell them I need 3 more appointments each with my hospital surgical weight loss program assigned NP and dietician, and they say "Well, we normally don't do referrals for those, since we have NPs and a dieticians on staff." I calmly explain for the 4th time that it is for a weight loss surgery program, which I was referred to by my PCP. They whine and complain ("6 appointments? That's a lot, we already had you down for 6 in the past 3 months...") and then they finally relent, but then ask for the provider's insurance number and fax number. WTF? I don't know? Shouldn't they be able to find this out in a directory somewhere? And fax number? There's not even a fax number on the hospital's website (because it's 2016). Then, I'll have the appointment, something goes through as a different provider (the head doctor at the hospital program instead of the NP for example), so it doesn't match up with the referral, and then I get a bill for $600 that I either have to pay for resolve. Variations of this have happened several times with appointments, imaging and blood work.

I have an Excel spreadsheet trying to reconcile the service provided, the provider, the charge, whether I got a referral for it, how much I was charged, etc., but it's all so disorganized. I'm pretty sure I've outright overpaid about $600 because of bungled referrals and had another $400 charged to my deductible when it should have been covered by just a co-pay.

I just want to know -- Is this normal?

[2goldengirl 2,076]

I would have to say no, it isn't normal, nor should you tolerate it. Get in touch with Tufts, and ask to speak with a supervisor. Explain the billing/referral issues and see whether they can help you. This is silly!