Payments > Insurance Payments

being charged OON for my daughters 3 month check up b/c they were neg. contract

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dianab:
They are in network and have been since my 3 year old was born.  They were "negotiating" their contract w/ BCBS at this time.  I wasn't aware of this, therefore, when she went to her appointment, I was "OON"

blhoffman:
May I ask who is the insurer? What state?

Pay_My_Claims:
uuugh @ BCBS

PMRNC:
Without being privy to their contract or terms with BCBS, you are sort of stuck, if BCBS says they were NOT in network at the time of service, then the balance is your responsibility. What is the carrier telling you as far as their participation stats at the time your services were rendered?

blhoffman:
My opinion would be to call the insurer and advise them that the provider was par for the last several years. When you went to the appt., you were not made aware of the contract neg. taking place or there was a recent change in their status. This same provider is now par again with the insurer. You would like a pay and educate done on this claim because you feel you should not be responsible for the payment of this claim, as it was not common knowledge of their status before the appt.

If they state you can't have it done and you have to appeal, then I would most definitely appeal. I have to say it again, ALWAYS appeal.

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