Specialist won’t see me without “insurance referral”, but my PCP sent in a referral already?
I am on a HMO plan through my employer, so I know that any specialists I see need to be referred to by my PCP.
I have a small lump in my abdomen which I’ve had for about a year now. I suspect it to be a lipoma but it’s in a very uncomfortable spot which has caused me discomfort for awhile. So for the last couple months I’ve tried to get it removed but it’s been a struggle dealing with appointments.
First, I made an appointment with my PCP a couple months ago. She suspected it to be a lipoma and gave me a referral to a dermatologist.
A couple weeks later I go to said dermatologist. He says that he won’t remove it because it should be further screened and if it gets taken out it should be done by a general surgeon instead.
Later I made a telehealth appointment with my PCP again to let her know what he said, and she gave me two referrals- one for a radiology place to get further screened, and one for a surgery center.
I call and make an appointment with the radiology place, no problems there. However, when I tried to make a later appointment with the surgery center, they said that I need an “insurance referral”. I inquired if my PCP sent in a referral and they said she did (and I can see in my health portal that she did). But they only have a “doctor referral”, but they need my PCP to send in an “insurance referral” because with my HMO insurance I need authorization. I was confused but said okay I’ll ask my PCP.
I contact my PCP office and they have no idea what I’m talking about. They said that if the surgery office mentioned “insurance referral” then I need to talk to my insurance but that my PCP submitted the full referral for me. Which makes sense because the other two specialists didn’t have issues with the referrals? I then contact Carefirst BCBS and they said they don’t know what an “insurance referral” is and that a referral is just a physical submitting it, which she did.
I’m so confused and defeated. Is there something I’m missing? Did the surgery center employee just make a mistake? I’ve been trying to take care of this for months and being told I “need to get my doctor to do something” and being told that doesn’t exist is so infuriating. Please tell me if you have any advice, thank you.
submitted by /u/say_ruh
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