9/2/20: I Guess I Don't Need Referrals Anymore?

According to my meticulously kept records, the referral for my medical oncologist expires today. I called my PCP's referral line to get a new referral for my new doctor. Surprisingly, they said a referral isn't needed because the specialist is in the same hospital network as my PCP. 

I asked if this is a new policy, and they said it's been in effect since at least February. I actually noticed that the referral I requested for my cardio-oncologist in August was not showing up in the online patient portal; they confirmed that they have a record of the request, and that a referral wasn't needed because the cardiologist is in the same hospital network. My online patient portal does show a new referral for my breast surgeon in June, and for my genetic counselor in July; they are both in the same hospital network, too, so now I don't understand why those went through, but I guess it doesn't matter, as long as my insurance covers the appointments.

8/3/20: The Cardiology Department Called Me

Someone from my hospital's cardiology department called and said my oncologist had put in an order for me to see a cardio-oncologist. This person was so pleasant and friendly, I wish all phone conversations with customer service and administrative assistants could go so well!

Normally, I'd have to go to the main hospital in the city, but I lucked out; the cardio-oncologist sees patients at a local satellite office once a month, and my appointment request came just in time for me to see her on Thursday at a nearby suburban site. It's not the same location as my Cancer Center, but about the same distance away in the opposite direction. 

I haven't heard from my oncologist's office. I'm guessing they won't call, and that the referral to the cardiologist basically serves as the "action taken" in response to my phone call. I do wonder... If I hadn't called them about my echocardiogram results, would they have called me? I have to assume that my oncologist saw the echocardiogram report. Maybe she wasn't worried and wouldn't have said anything, but the mere fact that I expressed concern prompted her to send me to the cardio-oncologist, since it's obviously something I want to address? Or maybe she would have called, but I just happened to call her before she got around to it? Judging from the responses I got to my posts in Facebook support groups, it sounds like seeing a cardiologist is the appropriate course of action, and it makes me think again about how important it is for me to be on top of my own medical care. 

Anyway, I didn't think of it right away, but a couple hours later I remembered to call my PCP's referral line to get a referral to the cardiologist. 

Incidentally, I also called them a couple weeks ago to renew my referral with the genetic counselor. I wasn't sure if I needed one. I don't think the phone call counted as an actual appointment, but I figured it wouldn't hurt to have the referral.

6/20/19 - 6/21/19: Phone Calls (Insurance Referrals)

It suddenly occurred to me to wonder if I need a referral for my breast surgeon appointment next Friday?

I called the Breast Center to ask. I left a message, and someone called me back first thing the next morning. She said from their office's perspective, I am all set. However, she suggested I call my insurance company, since they may require a referral for their own reasons.

I called my insurance company. They confirmed that yes, I do need a referral from my PCP to the breast surgeon. My existing referral (good for 6 visits in 1 year) to see my NP in the Breast Center uses my NP's "NPI number". I will need a separate referral to see the breast surgeon using the breast surgeon's "NPI number".

I called the Breast Center to request the breast surgeon's NPI number.

I called my PCP's referral line to request the referral (also good for 6 appointments in 1 year).

Then I suddenly wondered if I should have had a referral for yesterday's appointment with the genetic counselor.

I called the genetic counselor's office. I felt sheepish when I realized that I had called her direct line, instead of an administrative line. I figured since I had her on the phone, I could ask one question that had occurred to me: If I test positive for genes related to breast cancer, will the results be able to tell me if the gene came from my mother's side or my father's side? The answer is no.

Anyway, she gave me the NPI number for her supervising doctor (a medical oncologist).

Finally, I called my PCP's referral line again. I explained yesterday's unexpected and urgent appointment, and he was able to put in a referral (presumably back-dated) that would cover yesterday's appointment (again, good for 6 visits in 1 year).

What a lot of hassle. I'm not even 100% sure the genetic counseling referral was needed, but I figure better safe than sorry.

5/23/19: Phone Calls

Taking my PCP's advice, I called the Breast Center to inquire about my MRI appointment.

After choosing the automated menu selection for scheduling, the person who answered the phone said my timing was perfect; my insurance company had just approved the pre-authorization.

My NP had told me that the MRI should be done at a particular time during my menstrual cycle, so my MRI had to be scheduled during a specific window of dates. I made my appointment, which would be in 1 1/2 weeks.

I also took my PCP's advice and decided to schedule an OB/GYN appointment to discuss birth control options.

I loved my OB/GYN who saw me through the births of both my children. I also regularly saw an NP in the same office, and I loved her, too. A few years after having my second child, I figured my PCP could take care of my Pap tests and the prescription for my birth control pills, so I stopped going to my OB/GYN. That was about 8 years ago.

I started by looking up my old providers. Unfortunately, neither were still practicing in my area. Now that I had to find a new OB/GYN, I decided to look within the same hospital network as my PCP and the Breast Center.

I went online to cross-reference doctors in the hospital network at locations near me with the list of in-network providers listed by my insurance company.

I called up the local OB/GYN practice affiliated with the hospital. As a new patient, they randomly assigned me to a doctor, and luckily it was the one I preferred based on the online profiles. I made an appointment for the earliest available date, which was 5 months from now, in October.

Just for good measure, I also called my insurance company. I confirmed that I do not need a referral for an OB/GYN appointment. I also learned that I had met my personal deductible, so the cost of the MRI should be fully covered; I would only need to pay a co-pay of $100.

5/7/19 - 5/8/19: Phone Calls

This time I didn't hesitate to call my PCP. I told them about my second lump, and asked how I would go about making use of that Breast Center referral. They gave me a phone number for the Breast Center, a department of the affiliated hospital network. Once I had an appointment, I would have to call the hospital's referral line to get a referral for the particular provider I would be seeing.

I called the Breast Center. They said I could make an appointment with one of their nurse practitioners (NP), but because I could feel a new lump, they would want a diagnostic mammogram and ultrasound for the new lump first. Since those test results are available immediately, once I had that appointment set up, I could make the NP appointment for any time afterwards, even on the same day if possible. Helpfully, this person also informed me that there was a satellite Breast Center location closer to my hometown, so I wouldn't have to drive into the city. 

I called my PCP to ask them to submit orders to my Breast Imaging location for another diagnostic mammogram and ultrasound. They said they would call me when the orders are in, which they did later that afternoon. 

The next morning, I called the Breast Imaging location. My 3-month follow-up ultrasound for my 1st lump was just a couple weeks away, so we decided to move that appointment earlier, and combine it with the procedures for my 2nd lump. I was told that I actually would not need a diagnostic mammogram, because a mammogram had already been performed on that breast within the last 3 months.

Then, I called the Breast Center located near me and made an appointment with an NP. I made sure to ask for the NP's "NPI number", which I would need for the referral.

Finally, I called the affiliated hospital's referral line to set up the referral for my NP appointment.