I can't get my claims paid because my doctors aren't in network and there is no referral for them. Why do I need a referral for a family practice doctor that I've been going to for 30 years and he's the one that referred me to my neurologist. What good is it to pay $236 a month for nothing.
Customer Service Rep...Got a call from a customer service rep on behave of a patient. She was calling about a patients referral. After telling me that the patient didn't need a referral even though her card, emdeon and Availity site said referral required. She asked what tax ID we filed with. I told her. She rudely said that she does not need one for routine eye or diagnostic exam. So my next question was not even for diagnostic testing. This lady snapped at me like I was a child. And yes I yelled at her. To let her know you don't talk to me or anyone else like that. Explained to her. That HealthSelect has been kicking back claims stating that the patient needed a referral. And she never gave me a chance to tell her. We don't do routine eye exams. We are strictly medical.
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