Question:
GHI and Out-Of-Network Lap Band Surgery

Has Anyone ever went to an out-of-network doctor? If so how did it work out fo you. I really want to use NYU. I feel really comfortable with this team.    — Sciteach (posted on November 15, 2008)

November 15, 2008
When you say "how did it work out for you", are you referring to financially? If so, that all depends on your insurance coverage and the out of network benefits they provide and if they provide them. I can tell you that if you go out of network, be prepared to pay alot more than if you had stayed in network since the surgeon, hospital etc can balance bill you any amount not covered by insurance up to their normal charges. Not sure if this is the info you're looking for since you weren't specific.
   — [Deactivated Member]

November 15, 2008
I was a self pay for surgery, but in other circumstances I have gone to an out of network facility and doc and the charges were pretty significant. If you can afford it, go with who you are most comfortable with. It is very important that you "go with your gut"- no pun intended. Best of luck, Dawn Vickers
   — DawnVic

November 15, 2008
I am in CA and my doctor is out-of-network for all insurance. He is head of Cedar-Sinai lap surgeries and was hand picked by a doctor friend of mine for me. My insurance Anthem Blue Cross PPO covered what they would normally pay for the surgery and I paid the rest. They broke the fees down to surgeon fee and hospital fee. The hospital was in-network, so they paid the whole hospital fee.
   — SharonZ

November 16, 2008
I retired from NYC to Raleigh, NC. I did not have the choice except to use another surgeon. I had RNY at Duke. BCBS picked up everything for the hospital (I paid my deductible) but GHI only paid about 25-33% of doctors' bills. I had two hernias repaired at the same time as my RNY and my surgeon's bill was $16,000!!!! GHI paid $4,000. I am appealing their payout. I was/am in shock!! Sincerely, Rena
   — RenaMansi