Question:
Has anyone with bcbs gotten them to pay for a hospital that is out of network, my dr

office says that it is possible to get deemed in network, i would love to hear from anyone that has had this problem and how it was handled by bcbs. thanks    — kiwani (posted on December 15, 2003)

December 15, 2003
I see from your profile you have any HMO policy. I'm guessing that you can get someone out of network approved if the surgeon you are using is the ONLY surgeon in your plan that does WLS. Then it comes down to a situation where the plan approves this surgeon and the surgeon only has hospital priviliges at an out-of-network hospital. If there is another doc in plan that does WLS and the hospital he operates is in network then I would guess they will not approve it. I cannot give you any specifics as my BCBS policy is a POS and I could go anywhere. <p>If nothing else get them to agree to pay the out-of-network hospital at normal rates or worst case HMO rates and then you pay the difference. It will still be a sizeable amount but better than paying for it all. Good Luck!
   — zoedogcbr