Insurance companies have their clients attached to a ‘ball and chain’ by requiring referrals. You have a primary care physician (PCP) whom your insurance company says you need. They are responsible for your health and well being and are the first line of defense when diagnosing a problem.
All of this makes sense but what makes no sense is the fact that when the PCP ‘refers’ you to a specialist you need a formal ‘referral’ because the insurance companies dictate this as a procedure. These referrals are completed for you by the PCP’s office and are good for a number of visits or up to a year. The amount of paper work that is involved is monumental and becomes time consuming for the PCP’s office, the office you were referred to and the patient who needs to request that referral.
If your PCP fails to put a referral through, the patient will most likely be slammed with an enormous bill for which they are responsible for. The best course of action as a patient is to never assume that the referral has been done. Call and make sure you have a referral number. Ask for that number, write it down and take it with you when you go visit that specialist. Tell the receptionist you have your referral number and offer it to them so they can write it down.
I had a chance to speak with an employee who pushed the paper work through for this process and asked ‘would you lose your job if they did away with this process?’ She gave me a fast solid answer, ‘NO! I have more than I need to do and this is just an extra task!’ Why must insurance companies do business in such a way that has everyone attached to a ball and chain? When they say ‘jump’ someone is saying ‘how high?’ and this way of doing business really needs to be changed.
