UPDATE~ ~ PPO "In-Network" vs. "Out - of - Network" Plastic Surgeons

Hi everyone~
So, I've been going to my plastic surgeon (Out of Network) since Sept 2009 and as of Dec. 20th 2009, his office submitted my file to my insurance. "ANTHEM PPO"
In January, the doctor called and told me that my isurance didn't pay for the insurance.
Now recently in March 3rd, I called my isurance and they told me that they didn't have any files with my name on it. I called my doctor's office and they told me that most insurance companies do this to thier people. Soooo, I set another doctor's appt for today to see my surgeon and submit paperwork tomorrow.

So this morning..... I thought to myself, Let me go to my insurance website and see what surgeons are out there "IN NETWORK" ...(funny, in the same building in Beverly hills, there are 2 offices) I called to make an appt for next week and I made it VERY CLEAR to them that I had gastric bypass 20 months ago and that I wanted a consultation. I told them who was the surgeon that I was going to (out of network) and they asked me to bring my file with me next week.

I called my (out of network) office and asked them if I can have my medical file because I'm going to a IN NETWORK surgeon. The receptionist puts me on hold and my doctor picks up the phone and starts to tell me about the whole in and out of network surgeons..... I didn't tell him that I have already made an appt with a NEIGHBOR of his. LOL! but.... he did tell me to do some research and to really ask questions and to see their pictures of past patients. So, Im curious now. I will do my research, but really regret that I may have to start all over if he doesn't give up my medical file.

Whaaaaa! ;_( FEEDBACK or COMMENTS please.

Your medical file is just that - yours.  Now if YOU request a copy he could charge you a fee, however, if the other surgeon requests a copy then he can't charge them.  Legally - that's your information and he can't hold it.  Even though he's out-of-network, if your plan provides for out-of-network benefits then I would assume that he's received some sort of payment from them - yes?

My PS is in Encino and I had my PS at Providence St. Joseph's in Burbank.  3 weeks out from my TT and I'm completely thrilled so good luck to you on your endeavors...it's worth it!