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mopinko

(73,758 posts)
29. bark up the chain.
Wed Jul 9, 2014, 07:53 AM
Jul 2014

a friend of mine used to always say- the clerk is a jerk. by which she didnt mean their personalities, just that it is their job to say no.

copy that newspaper article and ask them why the hell they dont have the docs in their network. and just to be on the safe side, i would get those docs names and just look them up to make sure they actually ARENT in the network.
when they refuse to answer, dont ask to be connected to their super, make them spell out the name, then ask. then look them up and call direct when your call mysteriously cannot go through.

if you are too tired to call and yell at them, i can be your sister from chicago that is gonna straighten it out for you. they dont want to hear from your sister in chicago. but you cant help it. she insists on helping you get well, and she is f'ng sick of money and medicine together.

ftr, i had a small surgery scheduled today at a free standing surg center. in spite of the fact that the doc found a raging bronchitis at my pre-op, they kept insisting that i was still on the schedule until the got the report from the doc. they actually asked the anesthesiologist about it. he seriously insisted that if she cleared me, i was a go.

i put up a facebook post saying- at this point, if you arent worried about me, i'm worried about you.
the resched will NOT be at that center. it will be in the regular damn hospital.
that was just plain greed. so much for docs as gatekeepers for YOU.

Recommendations

0 members have recommended this reply (displayed in chronological order):

Not sure, SKP, contracts and insurance being what they are, elleng Jul 2014 #1
Thank you! NYC_SKP Jul 2014 #2
If there was no "in network" physician at that hospital who was there and able to handle your case Warpy Jul 2014 #7
Thanks, Warpy! NYC_SKP Jul 2014 #9
ARTICLE: Anthem lists Stanford area doctors as in-network, turns out they are not. NYC_SKP Jul 2014 #8
Could be. elleng Jul 2014 #11
That is with all insurance programs from medical to dental yeoman6987 Jul 2014 #13
They make exceptions for emergency services, I had a lot of things covered. NYC_SKP Jul 2014 #17
I wish you the best of luck yeoman6987 Jul 2014 #21
Oh God, I feel for you! MannyGoldstein Jul 2014 #3
Well, they do bring paperwork to read and sign as you're laying on a gurney in the hallway. NYC_SKP Jul 2014 #6
That's under duress. What choice did you have? MannyGoldstein Jul 2014 #10
Thanks. I did a little research. NYC_SKP Jul 2014 #12
As a member of the Medico-Industrial complex, I can assure you MannyGoldstein Jul 2014 #19
It's SUCH a racket Brainstormy Jul 2014 #34
Also complain to the hospital for not informing you they accept ACA, but don't ride herd on docs. Hoyt Jul 2014 #4
Will do, it takes a shitload of phone calls to get anywhere. NYC_SKP Jul 2014 #5
Rest. elleng Jul 2014 #14
Good advice. They aren't likely to pressure patient for months, and even then there are limits on Hoyt Jul 2014 #26
Yes and they'll be paid the undisputed amounts initially, elleng Jul 2014 #27
With my wife in Stanford for a total of a month in 2012 DJ13 Jul 2014 #15
This message was self-deleted by its author lostincalifornia Jul 2014 #18
Complicating matters, CoveredCalifornia had my correct birthdate, Anthem screwed it up. NYC_SKP Jul 2014 #20
This message was self-deleted by its author lostincalifornia Jul 2014 #24
This message was self-deleted by its author lostincalifornia Jul 2014 #22
This message was self-deleted by its author lostincalifornia Jul 2014 #16
The short answer is yes, but give 'em hell. Daemonaquila Jul 2014 #23
thank you for the help and the links. NYC_SKP Jul 2014 #25
Technically, yes but insurance may pay the charge JayhawkSD Jul 2014 #28
bark up the chain. mopinko Jul 2014 #29
Hey sister! NYC_SKP Jul 2014 #30
stbex's secret plan- you dont have to hit anyone with a hammer if you play it right. mopinko Jul 2014 #31
This sounds eerily familiar. WilliamPitt Jul 2014 #32
Thanks! Fortunately, the CoveredCalifornia representative was very kind and helpful! NYC_SKP Jul 2014 #36
I saw an article just this morning about a lawsuit against Anthem . . . StatGirl Jul 2014 #33
Thanks, this is most helpful in building my case. NYC_SKP Jul 2014 #35
Great! StatGirl Jul 2014 #37
Latest Discussions»Issue Forums»Health»Can an "in network&q...»Reply #29