Did Pacificare pay 100% of Rabkin's fee?

Pacificare HMO is supposed to pay 100% of the fees for surgery and hospital (except for his $3K followup), but Dr. Rabkin's office told me they might only pay 100% of "reasonable and customary" charges. Recently Rabkin started charging all the money ($12K) up front and leaving his patients to deal with getting reimbursed--and HE collects the money and then you have to get HIM to pay you back! Have you gone through this process and if so, what has your experience been? Did Pacificare HMO pay the full charges including hospital, and how long did it take you to get your money?? I want to thank everyone on this wonderful site for all the help and support you give to all!

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