I am assuming someone out there has faced this issue (I can't be the only one, right?).
My son is currently undergoing an evaluation at the University Autism Clinic in our area. He was referred for the evaluation by his psychiatrist. Both the psychiatrist and the Autism Clinic are out of network (of course!). Our insurance company requires that we have a referral from our primary care provider(PCP) for specialist care. Our PCP provided the referral for the psychiatrist & the psychiatrist provided the referral for the Autism Clinic. I have just learned (after two appointments at the Autism Clinic) that the insurance company will not accept the psychiatrist's referral to the Clinic because the psychiatrist is out of network. This means that we have to have the PCP provide the referral & the two vists we already have hade will not be covered :Hot Head:
Is there any way around this? We thought we were doing everything according to the insurance company's policies, but are now on the hook for about $1,000 in bills and may not even get the referral before the vist schedulaed in two days. If we don't, we will not even file a claim because the evaluation is 4 visits and costs $2,000. If all we have covered is the final visit, it will fall under the deductible and they will not cover anything anyway.
I am trying not to offend, but I am so angry with insurance companies right now & am convinced their primary activity is to find ways to make the process so confusing that no one can possioble navigate their regulations and actually get coverage.
Please let me know if there is anything that might work so that we do not go broke getting the evaluations my son needs to sort out what is going on with him. Thanks!
