Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 I recieved my letter of approval yesterday and was thrilled but as I read the letter over it makes me a little nervous. The letter is addressed to Dr R and it is from Blue shield of Ca Select PPO, it reads in part " Because you are not a Blue Shield participating provider, the subscribrer is responsible to you for all charges incurred. Blue Shield issues the explanation of benefits and any payment directly to the subscriber. Benefits are based on the Blue Shield allowable amounts, and are payable at the percentage specified in the member's Evidence of Coverage. When a member recieves service from a non-participating provider, Blue Shield's payment percentage may be significantly reduced. " I looked in my coverage book and it says they only pay 50% for non-participating providers. Today in a post I read that Dr R is a participating provider of bcbs of mn. Why not Ca. Do you think they made a mistake? This is sure an emotional roller coaster ride isn't it. My dear husband assured me that we will have Dr R do my surgery no matter what, but it bugs me that I am going to the least expensive Dr in the country for WLS and still they don't want to pay much. Thanks for listening(reading) to me worry. Marjory of Ca Quote Link to comment Share on other sites More sharing options...
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