Post by songbird177 on Jan 6, 2012 0:28:39 GMT -5
So I went to see what I thought was a new doctor in the same office today and found out it was the one I saw last time that told me to lose weight. Things were about the same this time. She told me that I was young and all I needed was willpower..
Also I had thought my insurance approved me to see my old surgeon (Which wasn't what I was trying to do. I was trying to get a referral to see a ds dr) but they informed me that my insurance had denied me, they resubmitted it and denied me again. The assistant even brought me back to show me the process, as I was throwing out ideas at her to try lol. Apparently, with anthem, you are part of a medical group and that medical group has specialists. My medical group only has 1 bariatric surgeon and he doesn't do the ds. This is the one they keep denying me too which is okay I don't want to get it done there if he doesn't do the ds. Anyhow, they can't specify 'ds' when they do the referral. It is done online and the only specialty that fits is 'bariatric surgeon'. So they told me there is nothing more they can do for me and that I would have to change insurance (which I can't, nothing to change to) or change my medical group (I can do this option but there is only 1 ds surgeon in california that accepts my insurance, since i have medi-cal (medicaid) as primary and he is not located in my city.
I think the only way to be in the medical group and get this surgeon is to have an l.a. based medical group which means having a primary care in l.a. Anyone know if it is possible to have a pcp/medical group that's not in the town where you live with anthem?
If I can't get a medical group that has this bariatric surgeon, is there any way to get a referral outside of the medical group? Or would self-pay be my only option?
Tomorrow I am scheduled to leave for l.a. for the seminar with this dr. Hubby insists that we still go as 'anything can still happen.' So will be out of town til sunday night. Hope everyone has a good weekend!
Also I had thought my insurance approved me to see my old surgeon (Which wasn't what I was trying to do. I was trying to get a referral to see a ds dr) but they informed me that my insurance had denied me, they resubmitted it and denied me again. The assistant even brought me back to show me the process, as I was throwing out ideas at her to try lol. Apparently, with anthem, you are part of a medical group and that medical group has specialists. My medical group only has 1 bariatric surgeon and he doesn't do the ds. This is the one they keep denying me too which is okay I don't want to get it done there if he doesn't do the ds. Anyhow, they can't specify 'ds' when they do the referral. It is done online and the only specialty that fits is 'bariatric surgeon'. So they told me there is nothing more they can do for me and that I would have to change insurance (which I can't, nothing to change to) or change my medical group (I can do this option but there is only 1 ds surgeon in california that accepts my insurance, since i have medi-cal (medicaid) as primary and he is not located in my city.
I think the only way to be in the medical group and get this surgeon is to have an l.a. based medical group which means having a primary care in l.a. Anyone know if it is possible to have a pcp/medical group that's not in the town where you live with anthem?
If I can't get a medical group that has this bariatric surgeon, is there any way to get a referral outside of the medical group? Or would self-pay be my only option?
Tomorrow I am scheduled to leave for l.a. for the seminar with this dr. Hubby insists that we still go as 'anything can still happen.' So will be out of town til sunday night. Hope everyone has a good weekend!
