My Insurance doesn't pay enough ... Blue Cross of California

[Phranp 46]

I live in Los Angeles. My surgery was approved by my Blue Cross of California. Both the doctor and the surgery center were contracted by my insurance. The surgery center refused to do my surgery because my insurance does not pay them enough to make it worth their while. I have tried a couple of other hospitals and they, although contracted with my insurance, will not do it because BC does not pay enough. I called BC and they said that yes, the hospital/surgery center has the right of refusal. Is there ANYPLACE that accepts the miniscule payment of BC of California in or around the Los Angeles area?

Along with several co-morbitities I have spinal stenosis. My feet and ankles are constantly swollen and my back is killing me. I need this surgery!!! I must find a hospital that takes my insurance.

[jujuvee 0]

I really don't have any words of wisdom in regards to your insurance company. I have United Health Care and they only paid 20,000 of my surgery and I am on the hook for the rest, so I am making payments on 11,000. I also am responsible for the cost of my fills.... Long story short... It's so worth it and It is changing my life.

How much are they willing to pay and can you make payments on the remaining amount?

[ParrotheadCathy 0]

I believe you posted this before? My comment stands. Call your insurer and ask them for a referral to a WLS and surgery center that accept your insurance. That's about the only way I can think of for you to pick someone who does. Bear in mind that just becaue you and John Doe #2 have Blue Cross of California does NOT mean that your insurance coverages are the same! Your employer likely negotiated the coverage for which it was willing to pay and John Doe #2's employer did the same. That could mean they each belong to a different pool even. So the only way to find out anything definitively is to call your insurer. Talking here, while full of support and great help, could only leave you comparing apples and oranges.

[chicamam1 1]

lst poster is right. u need to make more calls. are the surgery centers ur calling that are contracting asc?(ambulatory surgery centers) whate about an outpatient surgery in clinic? these types of surgery centers require less payment and do not have the high expectations of costs like a hospital facility charge which is really high. you are also a blue company which means u have access to any doctor or facility that is contracted with a local blue in another state. have u considered that?