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Obtaining Proper Insurance Authorization 
Our referral specialist can help you obtain the necessary referral authorization from your Insurance Company. Here are some hints that she would like to share with you.
The most important thing to remember, is to always let your Primary Care Physician (PCP) to know when you are coming in to see us. You will need a separate referral for each visit or procedure unless your first referral specifies followup visits or procedures. So you will need to contact your Primary Care Physician's office each time.
You may need to pick up a paper referral or an authorization number will be faxed to us. Ask your primary care physician's office which applies to you.
When you contact them, they will need the following information:
- your insurance
- date of visit
- which physician you are to see
- your diagnosis or symptoms (reason for visit)
- what service is to be done
- new patient visit
- return visit
- gastroscopy (EGD) "stomach scope"
- colonoscopy "full colon scope"
- flexible sigmoidoscopy "short colon scope"
- PYtest for Helicobacter pylori - ulcer bacteria breath test
- Esophageal manometry and 24 hour pH test
- at which facility you are to be seen
- Our office - The Center for Digestive Health and Nutrition
- If you are having a procedure done at Three Rivers Endoscopy Center or,
- If you are having a procedure done Sewickley Valley Hospital Outpatient Surgery
Try to give your Primary Care Physician's office at least 7 working days notice before your appointment to allow time for the following:
- your primary care physician must first OK your visit
- Then the referral request is called in or faxed to your insurance company
- where a doctor or nurse reviews your case and then either allows or denies your treatment.
Yes, they can deny your visit even if our doctors and your primary care doctor agree that it should be done. So, be sure to give your Primary Care Physician's office plenty of notice.
Another important thing you must do is to make sure our doctors:
and our facilities:
- Center for Digestive Disease and Nutrition
- Three Rivers Endoscopy Center
are participating with your insurance plan. You will need to check your Provider Directory. (Your insurance company usually sends you a copy, or you can call the Provider relations number on your insurance card.
I hope I have made the referral process easier to understand. If you have any questions, please feel free to give me a call at 412 262-1000 OPTION #4.
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