Be aware: BCBS users

[jane]

I just found out the hard way that it is very possible to go to an "in-network" hospital emergency room only to find out later that the emergency room physicians are "out-of-network"! The only way to not be penalized for going out-of-network, is to go through the entire appeal process each time. I have been told from the "higher ups" that this is the way it is and that there is nothing we can do about it. It seems to me that if a doctor chooses to work in a hospital contracted with BCBS, then it should be required of that doctor to also be contracted with BCBS. I don't think many people are aware of this problem and in my opinion, it's huge! Do we now have to call around to in-network hospitals to see if their ER docs are also in-network. If enough people find out about this problem, there must be something we can do.

 

[hr]

The way that I understand it this is a policy of the medical program option that you chose. I'm not saying that it was right, just that you chose that program.

 

[lacy]

This was not an option that was chosen. Any UPS driver that is a member of the teamsters has BCBS as their insurance carrier...we were not given a choice.

 

[proups]

lacy: I don't think HR meant that BCBS was an option - that is the carrier UPS contracted with in that area. The option HR was referring to was the option in the BCBS plan.

 

[lacy]

Proups...I hate to sound stupid, but what option in the BCBS plan? I wasn't aware that we had any options, only that if we stayed in-network everything was fine, but if we went out of network, there would be a penalty involved. Please let me know if I'm missing something here.

 

[proups]

lacy - I don't know where you are, and could not give you good information on your plan. Contact your HR Rep for answers. Good luck!

 

[lacy]

proups...I'm located in Orlando, FL. Does that help? I'm looking into things myself, but if you have any info, I'd really appreciate it. I still don't understand how you can go to an in-network hospital that uses out of network ER docs. And as far as I know we don't have any choices in our insurance other than using the names listed in the book or not...with penalty's. Like I said, any info you can give me would be great.

 

[trouble1903]

On an ER visit as long as you call in the visit with in the time limit you should be covered. (Meaning they will need to paid more then they want) Even if the doctor does not participate. Request the bill be reviewed, if they still will not pay it go to your local. If they are being snowed by the insurance bs, then contact your local banking and insurance comission. The last thing any insurance agency wants to hear is that you are calling the comission!

 

[lacy]

I just don't get it. Doesn't it bother anyone else out there that you can go to an in network hospital and they have out of network ER doctors? Going through the appeal process is a real pain. And the cost and really add up depending on what you went in for!