BC/BS and CHRIAS saga

Still can't seem to get a straight story. I was there last week. I was not allowed to see the doctor before paying $125. I insisted and spoke with the doctor of my concerns. I was told that in a meeting with the ins commisioner and CHRIAS--that if you had your surgery before the mess and you can only get aftercare at CHRIAS, your cost is IN NETWORK but you are to pay and submit to BC/BS. Of course BC/BS has told me it is out of network and I have a yearly cap of about $2000 and a deductible of $600. So I have still to receive a reciept that I paid or a claim form to be submitted to BC/BS--even though I insisted this through the office staff--then was told it would be faxed to me--needless to say. . . This whole thing is ridiculus. Perhaps some of us should seek some legal advice if this keeps up. I hate to say that because I have loved my surgeon and my experience up until now. It seems there is one story from CHRIAS and one story from the insurance comissioner. CHRIAS does deserve payment for their services, yet the only one this is hurting is the patient. That just doesn't seem right. I tried to be scheduled at Salisbury but they want you to pay $2500 up front for a program fee and after a year you pay $200 a visit.--which is for their gym and other stuff. . . it didn't matter to them that I live 2 hours away. The place in West Chester would not schedule me post op--when I called. So, I have no choice, and I have a lap band. NOt to mention the office staff at CHRIAS was more than unhelpful when I asked about referral information. The remark was "we don't have that information" You mean the two closest providers/bariactric offices you don't know and you can't find out? I found those numbers through a painstaking Google search. Because the office staff could not even tell me the name of the doctor--nevermind the practice. The last thing is that I paid for a visit and have recieved a print out from BC/BS saying they paid it also and would not reimburse me--it is currently under investigation. If I knew this I am sure I would have reconsidered my decision to have surgery. I think we should be receiving more cooperation from all parties. Some big money has already been paid to both CHRIAS and to BC/BS in their premium costs. Let me go meditate--in the past I would be looking for sugar right now--so I do thank CHRIAS for helping me gain control!

Hard to believe how disorganized this office and insurance stuff is. Two years ago this is what drove me to BARIX in Langhorne where things were handled well. Yes, an hour away but it all got done and correctly. Good luck to you all,

When reading your post sorry I didnt understand why when you paid for the visit that you did NOT receive a receipt at the time of service which most practices do. I do not know of a Bariatric Surgeon practice in the West Chester area that you speak of. Would you be meaning Barix in Lanhorne? If you google Bariatric Surgeons you may find that U of Pa 8th and Spruce and Eistein Hospital all in Philadelphia, Crozer Hospital in Chester all have Bariatric Programs. IBX.COM which is the website for BC/BS will list surgeons also. Each state does have a Board of Registry/Medical Practice that you may try to contact in order for a possible list of Bariatric Surgeons. I do understand your delema as I am a Bariatric/Lap Band patient myself as well as a Healthcare Professional. Be your own advocate I say and understand YOUR insurance coverage .There are Surgeons in the Tri-State Region that specialize in Bariatrics and perform the Lap Band and Gastric.

Thanks for the update. I guess I'd better start saving for my next fill. Fran