Why Do I Need a PCP Referral for My Dermatologist?
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I just called to schedule my annual appointment with my dermatologist that I have seen for several years. I was informed that – due to Obamacare – I needed a referral from my primary care physician before I can see my dermatologist. So, I called my primary care physician to find out I have to go there, I can’t get in for four weeks, and I will have to pay a co-pay for the visit.
SERIOUSLY!!! I thought this was healthcare REFORM???? Something that is (1) delaying the real appointment I need, (2) costing me time away from work for a primary care appointment I DONT NEED, and (3) costing me more money……..please explain how this is reform? I am absolutely disgusted about this!!!
David
Crappy answer. There is NO reason for my PCP to get involved if I want a skin cancer screening. Outrageously, I also had to go see my PCP to get a referral for a Shingrix vaccination. The doctor visit – just to get a piece of paper – cost more than the actual cash price (no insurance) of the vaccine. STUPID STUPID STUPID!!
James LaForest
I would like to see a dermatologist to test me for skin cancer, and other possible skin damage.
I have Medicaid through Meridian health care.
Do I need a referral?
Thank You
Mr. James LaForest
ObamaCareFacts.com
In general you do need referrals for specific treatments and tests, since that is true the best first step would likely be to ask your Primary Care Provider (PCP), you can also check with your insurer.
tae
so I live in the state of Colorado, I recently went to see a dermatologist because I have severe eczema. Had I known, which I didn’t that you needed a referral. So I called ahead to see if I could get in to see my primary doctor, they proceeded to tell me that it would be two months before I could get in. given this information I wasn’t ok with, I thought to go to an urgent care provider for my referral, called ahead and all. Got my check up and referral. Here’s where I start to get pissed off, I call to make my dermatologist appointment with my referral and they ask do I have a referral, ” yes” I said yes, right? they tell me they’re going to transfer me to a primary care provider, this lady then asks again do you have a referral. you know what I said. she proceeds to ask if it’s on paper or did the doc send it in. It is paper. SO she says you can either fax it or make another appointment with your primary care provider at your general hospital and get another referral,( in another month) and hope the dermatologist can fit me in. what is this flawed system?
ObamaCareFacts.com
Some types of plans require referrals to see specialists. The logic is it is supposed to keep costs down by having a primary doctor who knows the patient see them first and then approve the specialist (confirming if it is needed). It isn’t actually a system that relates to the ACA, it is simply a system used by health insurance companies.
Liberals suck
My health coverage was affordable and actually worked prior to obamacare. My insurance today (2018) is now almost unaffordable and covers things I will never use.
Why did the liberals screw things up so badly just so 1% of the population could get free insurance?
ObamaCareFacts.com
That is an overly simple take on the matter. Tens of millions were without coverage prior to the ACA, the steps taken to insure them, combined with all resistance, combined with the rising cost of healthcare in general, resulted in higher prices. There are lots of problems, some of those problems are things we can rightly hold liberals responsible for… but the healthcare crisis extends well beyond party lines. You’ll notice that the GOP hasn’t magically fixed our healthcare system, that is your first hint it isn’t “just liberals.”
Chrystal G Lee
My understanding, however, particularly, IN THE STATE OF FLORIDA,is that you DO NOT need a referral to see your dermatologist. Other specialist, yes, dermatology, no . If you participate in an HMO plan, you do, normally, need to get a referral from your primary care to see a specialist. If you have a PPO plan, you do not need to get a referral from your primary care doctor to see a specialist. Or, if you have what they call original Medicare (with or without a supplemental insurance plan) you, also, do not need a referral from your PCP to go to a specialist.
Dez Nutz
Shut the fuck up all you bad skin having racist. The only reason you have health insurance is because of Obama. Before that no one would accept you with your terrible preconditions or you flooded the county hospitals. Go see a Russian doctor, I’m sure there’s no wait, itchy ass!
Zachary
Just seen a doctor at the E.R about a week. Ago about a black spot on my foot concerned that it is Melanoma skin cancer now they told me to get a PCP then be reffered to a dermatologist now I already tried the ER thing and followed there instructions to get a PCP and cannot find a PCP I already called multiple offices and left voicemails nobody has returned a call wtf do i do serious medical concern no PCP can I just walk in to a dermatologist office and have them cut it out
Zachary z
Just seen a doctor at the E.R about a week. Ago about a black spot on my foot concerned that it is Melanoma skin cancer now they told me to get a PCP then be reffered to a dermatologist now I already tried the ER thing and followed there instructions to get a PCP and cannot find a PCP I already called multiple offices and left voicemails nobody has returned a call wtf do i do serious medical concern no PCP can I just walk in to a dermatologist office and have them cut it out
sonia mac
The “answer” provided does not answer his rhetorical question. He should not have to go to a primary physician again if he was already referred to his current dermatologist in the past.
He is asking why his medical record is being “reset”, as if he is wanting to go to a dermatologist for the first time.
Your answer was “because the new system is as circular as my answer”.
ObamaCareFacts.com
I get it. So referrals and new patients work differently. I’m not sure why he was told he needed to do this. My assumption was that with the new plan and new rules it needed to be schedule this way. A better answer would be, contact your insurer for an explanation, since this is in fine print territory and i’m not sure of an exact answer.
SHARON
(33) Notwithstanding any provision of this section to the contrary, a health maintenance organization which offers dermatological services shall provide direct patient access, for office visits and minor procedures and testing, to a dermatologist who is under contract with the health maintenance organization. The term “direct patient access” means the ability of a subscriber to obtain such services without a referral or other authorization before receiving services. The health maintenance organization shall, by July 1, 1997, develop criteria for compliance with the provisions of this subsection which do not impede or inhibit access to dermatological services for policyholders of the health maintenance organization. The criteria may include a maximum of five office visits to a dermatologist without prior authorization for a dermatologic problem within a 12-month period. *STATE MANDATE FOR DERMATOLOGY NO REFERRAL REQD *
Joey
> The long wait times are due to the demand for your dermatologist
So instead we have long wait times for a PCP (because everybody has to go through them to get the referral to the specialist they already know they need. And then we pay that PCP to TELL us that we need to see X specialist, which we already knew in the first place.
Christ. Just a admit your whole industry’s a racket, that you’ve got the country by the short hairs, and there’s nothing we can do about it. Knock off this “it’s for your own good” nonsense.
Unhappy skin health patient
Dumb healthcare policy. This is one circumstance you could be proud that you are not an American. You can see a dermatologist easily outside US.
Bray W.
Im 19. I have sever psoriasis, yet i have to wait 2 months before my pcp will see me- then im assuming it will be another 3 week wait after i get a referral to a dermatologist before i can see them. as for universal health care, please tell me that my situation isn’t flawed. please tell me “obamacare” isn’t flawed. please tell me that i will live to see age 20 because if this is the health care im going to be receiving, i might as well go to medical school myself so i don’t have to wait months on inept health care providers to prescribe me a simple ointment or steroid that will help my condition.
Richard Brahman
bureaucracy wins