I second Mark's opinion of Stanford's expediency and helpfulness with insurance matters. Scarlett (at Stanford) has been a dream come true, virtually getting all pre-authorizations from my insurance company handled within days.
That said, I recommend you follow up with your insurance company and insurance network (if you're on a preferred-provider plan) after your chosen medical facility gets all the insurance matters taken care of. That's because, through no fault of Stanford, I found my insurance company didn't get everything right. First, although I talked with three different people in the insurance network (First Health), none of them could locate Dr. Chang (meaning none could determine that he was in-network) -- this even though Dr. Chang is included in Stanford's group contract and has exactly the same tax id# as Stanford's (which facility First Health *could* locate/determine as being in-network)! First Health went through a software upgrade last year after being bought out by Coventry Health, and their records have been full of holes ever since. Some of their staff are very dysfunctional and under-trained, making matters worse.
Another problem I uncovered is that one of the "CPT codes" (insurance codes that identify medical procedures or tests) that was supposedly pre-authorized in my case was omitted by First Health in their pre-certification records -- when I called, they had no record of it having been pre-authorized. I have since called Stanford to ask them to kindly request that CPT code be added to the list of pre-authorized procedures for my care (in other words, tell First Health they screwed up and need to add that CPT code back to the list of my pre-authorized treatments).
Based on my previous experiences with First Health, I have no doubt that these problems were caused on First Health's end and that Stanford did their best to get everything settled on the first attempt. (Again, I've had many, many problems with First Health giving me wrong or incomplete info in years past; to my recollection, they have never gotten anything right on the first contact. I have had to appeal two decisions of theirs in the past year alone, due to their incompetence, and BTW I won both appeals.) My advice is: get documentation from your insurance company and take nothing for granted! Get it in writing. That way, if they bill you afterwards for something they said was covered, you've got proof that they're wrong.
Best wishes,
Tumbleweed
