Question:
My surgeon is in-network but the hospital she uses is not...
I do not have a choice which hospital to go to. My insurance (AETNA OPEN PPO) requires you to seek precertification of out-of-network charges prior to pre-op testing. does anyone know the liklihood that AETNA will pay at the 80% rate if it's the ONLY hospital available for my surgeon? — jenn2002 (posted on April 7, 2002)
April 7, 2002
When I first started researching WLS I made an appointment with a surgeon
who was on my insurance (Aetna EPO) but then found out the only hospital
available to him was not on Aetna. I called Aetna and questioned this
since there were about a dozen other surgeons in the area on their plan
with no other hospital. They told me if I were approved for the surgery
they would work out something with the hospital. I decided I didn't want
to go through with the hassle and made an appointment with another surgeon
whose hospital was in my plan. You might want to give Aetna a call and ask
them how they would handle your situation. -Margaret
— Margaret G.
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