How do you find out if a Doctor is "in-network" on Bluecross/Blueshield?

[Pinocchio Liberal 268]

Would you believe I just got off the phone with the insurance company over a nice fat bill I found in my mailbox just now.

$410 for routine bloodwork

So I call the insurance guy who tells me that he has to call the lab to find out what's going on and call me back tomorrow.

I get enough of this paper-pushing jobsworth bullsh!t at the office - I could do without a dose at home too!

Why on earth can this stuff not be done transparently - why does the patient need to be dragged into this?

Takes away from your VJ time?

[rebeccajo 14]

Would you believe I just got off the phone with the insurance company over a nice fat bill I found in my mailbox just now.

$410 for routine bloodwork

So I call the insurance guy who tells me that he has to call the lab to find out what's going on and call me back tomorrow.

I get enough of this paper-pushing jobsworth bullsh!t at the office - I could do without a dose at home too!

Why on earth can this stuff not be done transparently - why does the patient need to be dragged into this?

So that you won't want to have the routine blood work done routinely!

[w¡n9Nµ7 §£@¥€r 123]

$410 for routine bloodwork

That's strange. I've never had to pay anything other than my co-pay for routine blood work. Someone, somewhere, clearly dropped the ball.

[Trumplestiltskin 5,791]

Marc, is there any chance (any chance at all) that you go into your bathroom, put your head between your legs and disappear up your own arsehole?

$410 for routine bloodwork

That's strange. I've never had to pay anything other than my co-pay for routine blood work. Someone, somewhere, clearly dropped the ball.

That's what I would imagine too - I just don't get why I'm obligated to do other people's jobs for them under threat of a fat bill.

Edited November 2, 2009 by Gene Hunt

[rebeccajo 14]

$410 for routine bloodwork

That's strange. I've never had to pay anything other than my co-pay for routine blood work. Someone, somewhere, clearly dropped the ball.

Really?

With our last plan, bloodwork fell under the deductible.

[w¡n9Nµ7 §£@¥€r 123]

I just don't get why I'm obligated to do other people's jobs for them under threat of a fat bill.

The people doing their jobs aren't doing them very well. For all the ** talk of efficient corporations, they really aren't.

$410 for routine bloodwork

That's strange. I've never had to pay anything other than my co-pay for routine blood work. Someone, somewhere, clearly dropped the ball.

Really?

With our last plan, bloodwork fell under the deductible.

Yes, really.

[rebeccajo 14]

I just don't get why I'm obligated to do other people's jobs for them under threat of a fat bill.

The people doing their jobs aren't doing them very well. For all the ** talk of efficient corporations, they really aren't.

$410 for routine bloodwork

That's strange. I've never had to pay anything other than my co-pay for routine blood work. Someone, somewhere, clearly dropped the ball.

Really?

With our last plan, bloodwork fell under the deductible.

Yes, really.

Well, really, I think all I am saying is that not everybody's plan pays the same way.

[Trumplestiltskin 5,791]

I hope it is covered, I had to have 2 rounds of tests last month - if its not covered its going to be fvcking expensive.

[The_Dude 1,142]

Good god this thread is making me appreciate my health insurance and especially my employer for getting us the as AJ refers to it "Cadillac Coverage". Granted, i've never had anything more serious than a broken bone in my finger since i've had this coverage, but none the less, I think it's great all the programs we get. Preventative Health programs, countless workshops for various maladies. Really makes you think twice about looking on monster.com or careerbuilder.com.

[Pinocchio Liberal 268]

I haven't read this entire thread but I assume from the length of it that it isn't as simple as looking it up on the bcbsnj website? That's what I've always done.

I think 6 is talking about being absolutely sure the info on the site is correct. Because the phone rep couldn't confirm that it was.

Now we know why ppl want govy care! Cuz they cant even find a doctor even though they are covered. I know six and he's playin stupid to make some lame #### issue how healcare here sucks.

Next thing you know he'll be wantin the nurse to come pick him up and hold his hand. Then givem a sucker if he doesnt cry.

Just for the hell of it, I kinda hope that someday your insurance company starts making mistakes on your coverage and you find your mailbox stuffed full of denials.

Send me some more of that selective love!

[kaydee457 13]

I haven't read this entire thread but I assume from the length of it that it isn't as simple as looking it up on the bcbsnj website? That's what I've always done.

I think 6 is talking about being absolutely sure the info on the site is correct. Because the phone rep couldn't confirm that it was.

Now we know why ppl want govy care! Cuz they cant even find a doctor even though they are covered. I know six and he's playin stupid to make some lame #### issue how healcare here sucks.

Next thing you know he'll be wantin the nurse to come pick him up and hold his hand. Then givem a sucker if he doesnt cry.

How dare you interrupt his whining! Clearly HC, American Style, is over his head......

Edited November 3, 2009 by *entitlements_yay

[Trumplestiltskin 5,791]

I think some of you guys don't realise that there are real people on these boards trying to get advice for real life issues.

Seriously, what is wrong with you?

[Pinocchio Liberal 268]

I haven't read this entire thread but I assume from the length of it that it isn't as simple as looking it up on the bcbsnj website? That's what I've always done.

I think 6 is talking about being absolutely sure the info on the site is correct. Because the phone rep couldn't confirm that it was.

Now we know why ppl want govy care! Cuz they cant even find a doctor even though they are covered. I know six and he's playin stupid to make some lame #### issue how healcare here sucks.

Next thing you know he'll be wantin the nurse to come pick him up and hold his hand. Then givem a sucker if he doesnt cry.

How dare you interrupt his whining! Clearly HC, American Style, is over his head......

As if everyday life cant dish more serious ####### than what he's whinin about. Id be more pissed about running out of gas 5 miles from the nearest station.

[Trumplestiltskin 5,791]

Its easy to make light of other people's problems isn't it.

[Darnell 8,479]

So I'm trying to find a doctor on my insurance website - I've pulled up a list of providers near to my work and found one within a half-mile of here but for some reason I can't seem to find out from the insurance people if the person is covered as "in-network".

The customer service rep I spoke to apparently tried to call the provider but couldn't get through and told me to ask them if they are "contracted to the local bluecross/blue shield".

Is this really how these things are done - something that could mean my paying a co-pay at 100% coverage Versus 50% against a deductible is based entirely on my taking someone's word for it that they are covered!?

How can the insurance company not provide a straight answer as to who is covered under a plan? I mean... what is it exactly I'm paying them for if not to have this sort of information so that informed decisions can be made!?

When making an appointment with a physician from this directory, confirm with the physician before you receive treatment that he/she is participating in a Blue Cross and/or Blue Shield plan.

In order to receive benefits, services must be covered under the terms of your contract. The services to which you are entitled may not include every specialty offered by the providers listed in the directory. Please call the Customer Service telephone number on the back of your ID card to determine which services are covered.

Empire BlueCross BlueShield cannot and does not guarantee or warrant that files available for downloading from this site are free of viruses or codes that have destructive properties.

Empire BlueCross BlueShield and other Blue Cross and Blue Shield Licensees have made reasonable efforts to validate that the list of providers displayed is up to date and accurate. Please call the provider prior to scheduling an appointment to verify that the provider continues to be part of the network. Neither Empire BlueCross BlueShield, the Blue Cross and Blue Shield Association nor any of its Licensees shall be liable for any losses, damages, or uncovered charges as a result of using this provider locator Web site or receiving care from a provider listed in this Web site.

Data Changes, Daily

It's on yer head to make sure, for someone you've never seen before.

The majority of 'data systems' that handle this stuff are no longer written by USCs, who had a vested interest in the timely feeding of data into 'data systems' of this ilk.

Sorry !!