Blue Cross Blue Shield?

Has anyone heard any news as to whether or not Middlesex Hospital and Blue Cross Blue Shield has come to an agreement. Last news out was that they had not and Middlesex would now be out of network causing many of us to have to pay 20% of total cost.  I'm at my last of tests and appointments and would have to have to start over having to go to another Hospital and find another surgeon. I am not too sure I am comfortable with that as I totally convinced Dr. Aranow is definitely the one.   Getting Very Nervous!

Hi,
I didn't know this...but, with it being a bariatric center of excellence, BCBS should be accepted by a major hospital in CT.

Have you talked to BCBS and Dr Aranow's office about this?  I would check it all out.  Why are they NOT an "in network" hospital anyway?

Paula

 Hi Didi,

I just got my approval letter today from Anthem. I am finding myself in the same situation you are...the end of the road and not sure where to go. I have spoken to a few people and I am not sure if this helps, but quite a few people think that it won't continue. Middlesex will lose too much money, and Anthem also (having to shell out for more tests that people will have to take when they switch doctors.) I also spoke with the nutritionist when I had my last appointment and that seems to be the general consensus around there also.

But just in case....

I called Anthem and had them send me a Transitional Care Form. You and the doctor fill it out and they use it to decide to proceed with surgery at Middlesex, even if they can't come to a contract negotiation.

And last, keep calling Anthem and complaining. I talked to the HR department where I work and they said that if enough people voice their concern...it may "help" sway the decision.

I hope this helped.

Jessie

Hi and thanks for the replies. I have spoken with Dr. Aranows office and they seem to think it is not going to happen, however they did tell me that he is trying to get accredited to another hospital so I don't think he's as hopeful as they are putting out or he's just being practive incase. 

I also called BCBS and each person I spoke with said they knew nothing about it but did say that Dr. Aranow would still be in network which would mean just the hospital costs would be at 20% which in my case is still way too much at this time.

I guess we will see in 11 days.I'm keeping my fingers crossed and praying they come to terms. I am sooooo ready to have this surgery.  I am going to wait and see what happens before I call for the transitional forms.  If we all start doing that before the end of the month it will give BCBS the immpression that it is OK. 

Ok...Jl ............I just reread your post and I misunderstood the transitional forms. I guess that is what we should all do asap if your paperwork has already been sent in for approval. I'm sorry I misunderstood and spoke up.   What about if your paperwork has not been sent into bcbs yet. Will the transitional still apply?   This has got me so riled I can't think. Seems every time I shoot for something positive with this weight, something negative comes up that makes it all a catch 22.

Hi Didi!

I actually got the transitional forms before the doctor's office submitted my approval. I called Lois at Dr. Aranow's office and I now have a date for my surgery!!! But I also expressed my concern again about the negotiations between Middlesex and Anthem. She stated they were confident that things will be  negotiated...maybe they know something we don't?

I got more info on the transitional form. It is used if for some reason a certain test or procedure isn't covered by Anthem...whether it be the procedure itself, or the provider. In our case, if the negotiations don't go well, the form would explain that having our surgery at Middlesex would be necessary...and I am sure Dr. Aranow would have some supportive reasons.


Don't let it get you down Didi...we can only think positive.

Jessie

 

 

Thanks Kathy........keeping my fingers crossed. Just spent the last hour on the phone with Dr. Aranows office and then BCBS .

Again Dr. Aranows office feels that Middlesex and BCBS will come to terms although middlesex has come down 3 times and BCBS has rejected 3 times. Lois also said that the other possibility was that Dr. Aranow may end up doing surgeries at Bristol Hospital if these negotiations don't pan out.  It's all up in the air right now and they will not know till next week .

As for BCBS, that was just 45 minutes of total phone rat race for nothing.

I am just forcing myself to have positive thoughts that I will have this surgery in June. (30 day smoke free is what will bring it out to June)

This is so frustrating I bet. Something similar happened to a hospital back where I am from. It sucks when people get stuck in the middle of insurance politics. Good luck getting everything taken care of.