My neurologist (who I was referred to by my PCM) ordered a specific test and wants me to get it ASAP, as the results will significantly impact how a neurosurgeon (also an approved referral), and potentially other specialists, manage my case. I have already been speaking with my insurance and they will cover the test 100% with pre-authorization (Tricare). It is around $2k out of pocket, without using insurance.
The medical assistant at the neurologist office (a medical speciality clinic that has other specialists) is saying that they have never done a pre-authorization for labwork before and that it is “out of their scope” to submit it. In the online patient portal there is the order in there, as in it was sent to the lab so I can go in and get it. Is it possible for something to be able to be ordered by the doctor, but then out of scope to submit to insurance? Or is this complete BS?
ETA: I am mid 20’s and in Wyoming.
submitted by /u/randomuser2316
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My neurologist (who I was referred to by my PCM) ordered a specific test and wants me to get it ASAP, as the results will significantly impact how a neurosurgeon (also an approved referral), and potentially other specialists, manage my case. I have already been speaking with my insurance and they will cover the test 100% with pre-authorization (Tricare). It is around $2k out of pocket, without using insurance. The medical assistant at the neurologist office (a medical speciality clinic that has other specialists) is saying that they have never done a pre-authorization for labwork before and that it is “out of their scope” to submit it. In the online patient portal there is the order in there, as in it was sent to the lab so I can go in and get it. Is it possible for something to be able to be ordered by the doctor, but then out of scope to submit to insurance? Or is this complete BS? ETA: I am mid 20’s and in Wyoming.
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