Post by toytoy80 on Jan 8, 2012 18:13:01 GMT -5
Hi everyone. Wish me luck. I have to call my insurance company bc they said I am denied because Dr. K is not in network. Now this is after I called then before all of this and they confirmed that he was indeed in network and Dr. K's office called and they told them I was in network. Dr. K's called me at 530 my time so insurance was closed. My insurance is an HMO but I do have what is called State of CT bluecare POE. This means Benefits are only available from network physicians. You’ll have modest copayments for office visits, preventive care, plus vision and hearing exams.
If you need to see a specialist, there’s no need for a referral.
The State BlueCare Network
State BlueCare POE is served by a statewide network of credentialed medical professionals, who have been selected based on standards of education, training and accessibility. And State BlueCare POE features national access. This means:
Extensive local hospital network and 5,800 hospitals nationally are in the network
Over 17,000 Connecticut and 898,000 national providers are in the network
National network
You also have access to doctors and hospitals across the country and
around the world. Through the BlueCard® program, you can use the
networks of other Blue Cross and Blue Shield plans across the United
States. With the BlueCard® Worldwide program, you have access to doctors
and hospitals around the world. So you can get the care you need – just
about anywhere you travel.
So after looking that up which tells me I am covered nationally (i think it is a special program Anthem has with State of CT employees) I went to my anthem.com and put in Dr. K's name using my insurance plan and this is what I came up with:
ARA KESHISHIAN MD
Male
General Surgery
Compare
4.51 miles away
1808 VERDUGO BLVD, STE 413
GLENDALE, CA 91208 LOS ANGELES
818-812-7222
Doctor In-network
So I don't know if a mistake was made and somehow they didn't include my bluecare national coverage but I might not have the name and time of the person that spoke to me that assured me he was in network but their website sure doesn't lie. I am just going to ask to speak to a supervisor on Monday and let them know the situation and HOPEFULLY it won't be too much of a hassle but if not appeal here I come.
I hope this is not a big fight ahead of me. Somewhat nervous and haven't had been able to sleep. Will let you know how it turns out.
If you need to see a specialist, there’s no need for a referral.
The State BlueCare Network
State BlueCare POE is served by a statewide network of credentialed medical professionals, who have been selected based on standards of education, training and accessibility. And State BlueCare POE features national access. This means:
Extensive local hospital network and 5,800 hospitals nationally are in the network
Over 17,000 Connecticut and 898,000 national providers are in the network
National network
You also have access to doctors and hospitals across the country and
around the world. Through the BlueCard® program, you can use the
networks of other Blue Cross and Blue Shield plans across the United
States. With the BlueCard® Worldwide program, you have access to doctors
and hospitals around the world. So you can get the care you need – just
about anywhere you travel.
So after looking that up which tells me I am covered nationally (i think it is a special program Anthem has with State of CT employees) I went to my anthem.com and put in Dr. K's name using my insurance plan and this is what I came up with:
ARA KESHISHIAN MD
Male
General Surgery
Compare
4.51 miles away
1808 VERDUGO BLVD, STE 413
GLENDALE, CA 91208 LOS ANGELES
818-812-7222
Doctor In-network
So I don't know if a mistake was made and somehow they didn't include my bluecare national coverage but I might not have the name and time of the person that spoke to me that assured me he was in network but their website sure doesn't lie. I am just going to ask to speak to a supervisor on Monday and let them know the situation and HOPEFULLY it won't be too much of a hassle but if not appeal here I come.
I hope this is not a big fight ahead of me. Somewhat nervous and haven't had been able to sleep. Will let you know how it turns out.
