So from about 2009 to 2014 I had multiple surgeries on my thumb and wrists all performed by the same orthopedic surgeon. About a month ago I had a reinjury to my thumb, so I immediately made an appointment with the same specialist who performed the surgery to have it evaluated. Long story short, my primary care physician actually denied the referral simply because the specialist is not a doctor of the same hospital as my primary care physician. The specialist however IS on my health insurance network. My PCP even referred me to other orthopedic surgeons he would like me to see instead that are part of HIS hospital network (Lahey in Massachusetts – FYI) but apparently will not approve the referral to see the specialist I am comfortable with and have a history of working with.
Can my primary care actually do this? I am going through an appeal process but could be on the hook for some big hospital bills due to receiving care and consultation already without a referral.
Anything is appreciated
submitted by /u/DifficultBug0
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So from about 2009 to 2014 I had multiple surgeries on my thumb and wrists all performed by the same orthopedic surgeon. About a month ago I had a reinjury to my thumb, so I immediately made an appointment with the same specialist who performed the surgery to have it evaluated. Long story short, my primary care physician actually denied the referral simply because the specialist is not a doctor of the same hospital as my primary care physician. The specialist however IS on my health insurance network. My PCP even referred me to other orthopedic surgeons he would like me to see instead that are part of HIS hospital network (Lahey in Massachusetts – FYI) but apparently will not approve the referral to see the specialist I am comfortable with and have a history of working with. Can my primary care actually do this? I am going through an appeal process but could be on the hook for some big hospital bills due to receiving care and consultation already without a referral. Anything is appreciated
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