ANYONE WITH HMO BETTER READ THIS!!!!!

Ok I was just recently approved on 3-22-04. What I thought was going to be my happiest day just became one of my saddest. BCBS of GA just told me that I was approved for the physician but not the hospital that he does surgeries at is not in the network and they refuse to pay for it. They are now wanting me to find a hospital in the network. When I first started the journey 6mos ago, no hospital was nearby. Now a new bariatic program is starting up where I live and they want me to start all over with the process again. Im so discouraged. That would mean going back to my PCP and doing all the referrals again and then submitting everything to insurance. I dont understand why they cant just change the doctors name of the form instead of making me do everything over. I should hear something by tomorrow. If you have BCBS or any HMO just be sure they are in network because if a program comes up in network closer to you, then they are insisting that you change to that program. Thanks for listening

Approvals can be moved from one surgeon to another in no time. I know because I was approved for one surgeon and had it changed to a different one in 1 day! Find another surgeon in your network and let them know up front that you have been approved and they SHOULD take care of changing the approval for you. If they dont, you dont want to go to that office anyway! Best of luck to you. Sidney

This is normal in that HMO's do not pay for out of network anything. However, it should not be such a problem to transfer from one doctor to another if you have already completed testing, etc. You should call the new doctor office and explain your situation and that you have already been through the process of testing, etc. Hopefully they will not make you do everything over again, but you will have to be resubmitted by the new surgeon. Christy

I was going to change my surgeon and have bcbs of ga also. They were going to have no problem going from Smith to Hart. Just a peice of paper and it was done and hart could have done me in april. I decided to stay with smith and my appt is May 10th but they had noooo problem changing my surgeon. They were going to use the same paperwork and all. A approval is an approval ask for a supervisor call back on this one NAT