Pattibobatti--never, ever believe or take the word of the first reply you get from your insurance co. After I got certified at HEI for my AN surgery and had the actual surgery--a month later I recieved word that they would not cover the bill of Dr. Hits, the surgeon who did the "scoopin" (as opposed to the fellow who did the "openin") because according to them, more than one surgeon was not required to do the surgery. Remember, this is AFTER the fact and after geiing certified to have the surgery there at all. Dr. Hit's bill was $14,000 and they weren't going to pay it.
One call to Dr. Hit's office was all it took. His office sent a scathing letter to my insurance comapny and they paid 100%. Then they billed me for out-of network--the whole thing. House is most certainly in my network (BCBS) That took another 2 months to clear up as did another $600 work of billing boo-boos, all BCBS mistakes. As wonkyheaded as I was I went over every itemized bill with fine toothed comb. You need your doc or even a counsellor to advocate for you! I'm lucky enough to have found a BCBS adjuster who I called over and over again--getting the same person on the line everytime you have a question or issue who knows your case is beneficial as well.
Capt Deb
