Question:
How do you get coverage out of your PPO Anthem BC & BS

I had surgery in 1982 and therefore could not find a local doctor to do my Roux en Y. I have found Dr. Phillip Schauer at the University of Pittsburg Medical Center who is willing to do the surgery on me, but now they are not in my PPO's System. My primary care physician has referred me, but said they don't know if Anthem will cover it. Help!!!    — Thomas B. (posted on October 19, 1999)

October 19, 1999
Would Cleveland be in your network? Is there a reason why you have not investigated the surgery in Cleveland? I also have BC/BS, but not an HMO or PPO. Being in Pa. Cleveland is out of network, but there are no docs in my network who do the surgery. Amazingly BC/BS approved me in LESS THAN 7 days. Cleveland says, even if they only pay at 50%-out of network coverage. (not yet confirmed-They should be covering at 80% cause there are no in network docs.) There would be absolutely no out of pocket for me. E-mail me if you want info on Cleveland.... [email protected]
   — Connie H.