HMO out of group referrals
Posted: 2010-05-31 14:04:33
I am having a problem with my Koch pouch (leakage etc.) and there is no doctor in my HMO group that can handle it. I am being referred to Dr. Worsey at Scripps which I am pleased about but everything takes so long. I cannot make an appointment at Scripps until there is a letter of agreement. They also inform me that I will need a pouchoscopy (which makes sense) but I am only being approved for a consultation. The original surgeon's office I saw said they do not do a referral for the pouchoscopy and it will need to be done by Scripps. This will mean an almost pointless visit for a consultation and then waiting for another letter of agreement. I am fairly certain that the valve has failed and I will need surgery which will need to another wait. Has anybody had experience with dealing with this and suggestions to get things moving and cut through the red tape. I will be changing insurance on August 1 as I will be under Medicare. I will be using the same doctor's group but if this drags on, I don't know if it will put me back to square one. It has already been over two months since my GP did the initial referral to the in-group surgeon. Any suggestions would be much appreciated.
Thank you, Iris
Thank you, Iris