Out of Network - What do we do now?

Now that Chrias is no longer in BCBS network, what do we do about follow-up visits, problems, emergencies and etc. I don't have the funds to pay the full amount of out of pocket for any of these. What if any alternative is out there, is there another surgeon or practitioner in net work that will take over the on going care for lap band and WLS patients.

Hi! My understanding is that you just have to pay the nonprovider co-pay. For me I think that is 20%. I don't think you have to pay the full price of each appointment. What do others think?

I spoke to CHRIAS this morning (didnt get far) I am Global for 90 days again since having the 3rd surgery on my Band. After that time I was told I will have to pay for the out of network charges. I called BC/BS and they do not know anything about CHRIAS being out of network yet. In fact the BC/BS Rep said oh my we at BC/BS have PAID tremendous amounts to them and Christiana with pending charges that should be paid. No kidding can we say over 100 grand in a year. I called many Philadelphia surgeons also to see if I could be seen to No Damn Avail! Not that I am not happy with Dr Irgau because he is terrific, but I dont have the $$$$ like everybody else. Unless I am Pre-op no one that I called will touch me. GEEZZZZZZ Between a rock and a hard place and I am still sick.

I'm sure the dollar amount CHRIAS has been reinbursed is well over 100 grand. I'm also sure they have very high overhead especially insurance cost. But the bottom line is there are hundreds of patients who have no recourse for follow-up treatment. Is it only about the money for CHRIAS and BCBS what about patients health.

I understand that there is a Bariatric Doctor in Chester Crozer Medical Center (Upland, Pa about 5 minutes over the Delaware boarder) and that he is in network with alot of the B/C B/S insurances....His name is Dr Katz, he took over for Dr Cha........I have B/C B/S Personal Choice and CHRIAS told me last Thursday that as of now I am in network with the Personal Choice...Hopefully they are right. Good luck everyone..Dave

Dr Katz will not see post op Bariatric patients per his coordinator or atleast what she told me today. No one else in Philadelphia will either problem or no problem. Seems they want you from the Pre-op stage or nothing. No matter what ones insurance is....

I was told by CHRIAS that effective 12/15/2006 they would be out of network with my insurance. I have BC/BS Personal Choice. They stated that I would have to pay the full amount for the office visit which is $125.00 and CHRIAS would bill the insurance company for me. The insurance company would then reimburse per out of network agreement....my plan is 70/30 meaning they will reimburse 70% and I will have to pay 30% of it when all is said and done. My concern is not the doctors visits....my concern is what if I have to have some other surgical procedure. This puts all of us in a very vulnerable position. I knew this was a possiblity going in to the surgery because they were negotiating with BC/BS then....I really thought they would work things out and they would stay in network, I guess it was wishful thinking. Lisa

I called CHRIAS today and cancelled my appointment that I had this Thursday because I really don't have $125 to put out right now. I rescheduled for February and was told that they hope to have it all straightened out by then and hopefully be back in network. We can only pray that it works out that way. I can handle a visit here and there but as others have said I don't know what I will do if I have an emergency. Ellen

This is my first post here. I had to share my last conversation with CHRIAS about BC/BS. I called last Friday (12/15) to get a surgery date and Misty told me CHRIAS was now out of network but to call back after the first of the year. Interesting, no? My primary insurance - Coventry - completely excludes any bariatric surgery so I'm depending on BC/BS through my husband. Self pay with CHRIAS is $21,000. That's the last resort. All of my pre-op work is done except for the endochrinologist at PMRI (Jan). It looks like I'm going to have to go to Chester. I think it really stinks that those of you who are post-op are having problems getting a doctor. There's something wrong with the system here.

I was seen last week on 12/13. I was also told that the cost of a visit will be $125. My insurance company and the letter that I received from the Insurance Commissioner told me that Dr. Katz is accepting all of the patients from CHRIAS. From what I have read in the posts, this is not the case? I guess I will call both BC/BS and Dr. Katz tomorrow to find out. Like many others, it is not necessarily the cost of the visits, although they are steep, my concern lies with am I to do incase of an emergency?? This is completely incomprehensible to me.