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Wiki referring physician

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joy63

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Having denial problems. can someone please remind me the rule for when you do or don't use a referring physician for medicare and commercial plans. we are using our doctor if a referring dr is not listed when x-rays or a procedure is performed. some insurance co are denying, can we or can we not do this? getting different answers from different sources. confused!!

Thanks for your help
 
This would really depend in each insurance company and the pt's individual policy. UHC for example, one pt may need a referring physician, but another may not. The best thing would be to contact the insurance company. Are you getting authorization for the procedures?
 
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