Did Pacificare HMO reimburse you for all of Dr. Rabkin's fees?

I was originally told that Pacificare HMO would reimburse me 100% for all of Dr Rabkin's fees (except for the $3K followup) and the hospital's costs. Now his office is telling me that the insurance will only pay 100% of the "ususal and customary" costs, and since he charges more than other doctors, I'll have to make up the difference. Also, he now requires payment of the $12,000 up front, makes the patient deal with the insurance for reimbursement, AND has the money sent to him and then makes you wait to get it back! Luckily I can pay up front, but I DO need the money back. This is making me angry and nervous! He is the only DS doc in my network. How much were you reimbursed and how long did it take--or are you still waiting??

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