Anthem - Norton dilema

How many of you guys are in the same boat? 

I had an appt with my PCP this week that I had to cancel.  She wanted to do a checkup to see where I was since surgery.  I have my appt with Dr. Shina in Aug.  I didn't have to go.  I just wanted to.  I wanted to see what the scale said at her office and see what she had to say.  I kept thinking the issue would get resolved.  It looks like I will have to be finding several new Drs.

Thank God that this happened after my surgeries.  ARAD, how are you doing? 

Did anyone find out about LeeAnn.  Did she have surgery?

Becky does your Anthem have out of network benefits in your contract.???   I am in the same boat as my PCP is part of Nortons and so I can still see him but my copay goes up higher/   Now Dr. Shina is not a paid physciain with Nortons so he is ok to see no problem but if your PCP is then you need to check to see if you have out of network benefits

I wish all of you with Blue Cross Blue Shield the very best. I know you are all in a pickle right now.
Good luck with it all.

Hi Becky,

I am also an unwanted love child of Anthem/Nortons.  I just keep hoping that they well get their heads out of their butts soon and find a middle ground that they can both agree on.

I am self-pay for bariatrics so for the most part I wasn't going to be affected for that anyway.  The good thing though is that the USA surgeons are NOT a part of Norton's so they should all continue to be covered (per USA).  The other good thing is that Doc Larson does has admitting priviledges with Jewish which is also not part of Norton's so for my general surgery needs I can still use my guy!

My PCP is under the Baptist umbrella so no real worries there although I had previously prefered to keep as much as possible withing the Norton's realm simply for the sake of having one access for medical records.  I refuse to think about all the various specialists I am going to have to replace right now.  I keep holding out hope that they will get thier act together in the next week or so.

Wanna join me with my head in the sand for a few more days?

I had to switch surgeons and switch hospitals, which I am not happy about. But I don't have a choice. I am really upset with Norton. I can't imagine the amount of money they are losing out on over this. This past week was a nightmare as I was trying to find a surgeon who would take me and then try to have my surgery scheduled around the same time. I have a friend who already bought airfare to come in and help me for a few days after my surgery and my son is going to be at my parents house until the second week of August....so I really needed to have it around the same time.

I ended up going with Dr. Oldham and my surgery will be at Baptist East Hospital on July 20th. They tried to schedule me at Central Baptist in Lexington, but I did not want to have it there. I was then told that Baptist East has only done one RNY surgery before and I just don't believe that. Dr Oldham has done hundreds, so I am comfortable with that.

This whole thing is a huge mess. I feel really bad for other people who are in the same situation.

Oh, I forgot to mention that my policy did have out of network coverage and I could have still had it at Norton, but I would have had to pay DOUBLE of what I would pay with an in network hospital.

Dr. Geller wasn't the problem; he is not strictly a Norton doctor. However, he only has surgery priveleges at Norton. So that is what left me in a big bind.

And I do know that LeAnne is home from the hospital. I sent her a note and am waiting to hear back from her. I think she got home early yesterday or today.

I had Dr. Oldham and Dr. Weiss.  They are great guys.  did my surgery in Feb of this year.  Had it done at Central Baptist in Lexington and everything went pretty well.  I'm sorry you guys have hit this major roadblock.  i will keep all of you in my prayers and hope there is a resolution soon.
Becca  

Be careful with Dr. Oldham at Baptist East. I don't think they have even done one gastric bypass there yet. And neither Dr. Oldham, Weiss nor the new guy, Denk,  even live in Louisville. I bet you wont even see them after your surgery as they have a way of having their nurses do all the followup.

Also, make sure that Baptist East is in-network for Bariatric surgery as they may not be. If you read your policy closely, only BLUE BARIATRIC CENTER of DISTINCTION are in-network. Even though you might be able to get a gastric bypass at Baptist East with BCBS, it is my understanding that BCBS treats that as out-of-network. So you might as well be out-of-network wtih the doctor you prefer.

None of the Norton bariatric doctor's are employed by the hospital so they still are all in-network with BCBS, just the hospital is out-of-network.

I hope this helps.

Holly

Thanks for the info. I just called BCBS and they read through my policy and told me that bariatric surgery at Baptist East will be in network for me. They told me as long as Baptist East remains on contract with them, the surgery will be handled as an in-network procedure.

I have heard that Baptist East has only done one other RNY surgery before. This does alarm me somewhat, but I simply have no other options, unless I were to pay out of network. I called University Surgical Associates (which is the group that Drs Rodriguez, Tanner, Larson are a part of) and they only do their bariatric surgeries at Norton.

So, in a nutshell, Norton has really screwed me over.

I really don't know what to do. I wish I had the money to pay the extra cost associated with being out -of-network, but I don't. The deductible and percentages of what I will pay are DOUBLE of what I would pay if it were IN NETWORK.

*Sigh*

I would have to go out of network for my PCP.  That includes meeting the deductible.  So, it isn't worth it to me.  I will just have to go to another Dr.  I keep hoping that they will have some sort of resolution.