Pathway X Tiered - Anthem Blue Cross of CA?

[readyfornewme 6]

Hi All,

So I've gotten the ball rolling slightly... but I've already hit a slight speed bump. I've given my surgeon's office all my insurance info in order for them to verify that my insurance covers the surgery... and the coordinator calls me today saying that my insurance covers the procedure, and that the doctor/hospital is in Network, AND they're a center of excellence... However, she says since I have EPO I'm also a part of Pathway X Tiered? And my doctor doesn't have a contract with them?

The coordinator told me sometimes they can work around it, so I'm just waiting for a call back from her. Slightly bummed out because if it turns out I can't get the procedure done with them, I won't know what my next step would be. I also really like the doctor/hospital. It's Keck Hospital in Los Angeles and the surgeon is Dr. Katkhouda.

Kind of a confusing situation, so I just wanted to pose the issue here and see in anyone has had any similar issues?

Thanks for any feedback in advance!