Question:
Approval to see an out of network physician

I am an employee at Ochsner. My insurance is through Gilsbar. There is only one doctor that Gilsbar will cover and the doctor just started performing the surgery in December 2003. Can anyone give me any ideas how I can go about getting approved to see an out of network physician?    — Kimberly D. (posted on March 12, 2004)

March 12, 2004
First I had to get a doctor in network to refer me to the doctor out of network. Even then my insurance said they would permit the surgery only if I paid 35% rather then the 20%. I agreed. They were calling me weekly tring to talk me into going to a doctor in the network. They even called the day before my surgery and said how much money I would save going in network. I said no. I had the surgery. My total bill was almost $17,000. Insurance has now covered everything but $2,600. For me it was a hard battle because I live near Rochester Minnesota and the Mayo clinic. And the town I live in is part of the Mayo system. And I had Mayo insurance, so going to anther doctor was a big request. Good Luck.
   — Mini Gadget