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Round & Round with Dr. & insurance company

Catavenger

New member
SUPER Site Supporter
Last year I finally got approval to see a Dr. who is a neurologist who specializes in epilepsy. She set up an appointment for me to see another Dr.; a specialist about getting a memory test. The test was scheduled for the morning of Monday Jan. 13th.
I had been unhappy for some time with the insurance company I was using so changed it for 2014. I have already had to call the new co. a few times and was happy with their response. No long wait times, courteous people who spoke English etc.
Monday the 6th: since the Dr. who does the memory test is in a large medical complex that is laid out something like a maze. I looked on his website to see where his office is. On his website it also showed the insurance companies that his office accepts. My new company was not on it. The website also said something like when in doubt about what they accept call them. I did call them and was told by them that they do not accept my insurance company but would if they got a referral from the neurologist or my primary care physician. Since it was my neurologist who wanted me to see the memory Dr. and it was her office that was more familiar with my epilepsy and since she is even in the same medical complex as the memory doctor I called her office for the referral. I was told that they would pass along what I needed to the person responsible for sending referrals. Wed. I called the memory Dr.'s office to see if they had gotten a referral. The woman I spoke with said she didn't know but she would ask the "girl" who works on the referrals about it.
Since my appointment was scheduled for Monday Jan. 13 I was kind of concerned and decided that If I didn't hear anything sooner I would call the memory Dr.'s office again Fri.
Friday afternoon I called the memory Dr.'s office to see if they ever got the referral. The person I spoke with then told me that I didn't need a referral. This just didn't sound right so I called my insurance co. The insurance co. said that even if the Dr. accepts their insurance I need a referral to visit ANY specialist. I ask if that meant that I needed a referral to see my neurologist. Yes indeed I was told I do. A referral from my primary care Dr.
So not only can't my neurologist refer me I need a referral to see her. By this time it's after 3 in the afternoon. I also have an appointment to see the neurologist Wed. Jan.15. I called my primary care Dr.'s office and quickly explained the situation. I had little hope that they would be able to get a referral to the memory Dr. by Monday morning but was more hopeful that they could get one to my neurologist in time for my Jan. 15 afternoon appointment.
I called the memory Dr.'s office to explain what the insurance co. told me and that I had called my primary care Dr.'s office but that it was doubtful that they would get that referral in time. The staff member assured me that they didn't need a referral and anyway they had gotten a referral from the neurologist. I had to explain that was not good enough that MY insurance company said the referral had to be from my primary care physician. She then told me that she would call my insurance co. and talk to them. After a few minutes she called back and insisted that she had talked to Juan at my insurance co. and said that (according to Juan) I didn't need a referral. I said that there could be a million and "JUAN" Juans there and since I had no way to confirm what she said it was no good to me. She then told me that it was up to me that I could reschedule the appointment. I said yes I will do that. I was told the soonest I can see him won't be until AUGUST!
Monday I am going to call my neurologist office to see if they have gotten the referral from my primary care physician for the appointment to see her next week.
 

rlk

Bronze Member
GOLD Site Supporter
Cat, I think you're over thinking this. Just show up on the 13th for your scheduled appointment and let the office staff work it out.

Bob
 

Catavenger

New member
SUPER Site Supporter
To late now I cancelled it.

I have to think this through because these specialists are very expensive.
If this isn't done right I could end up with a bill for several thousand dollars no joke.
 
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