Frustrated!!!

I was on step 10 of 12 with the Kaiser Fremont plan, hoping to have surgery this fall when my husbands employer decided to switch insurances from Kaiser to Blue Shield!!!! So now I guess I will have to start all over. Does anyone know how this works and what Blue Shield requires. I am sure I will have to find a doctor in my area....which is Modesto. Any suggestions?

I am not sure what the process is but I can suggest a Dr. Alot of people use Pactrick Coates, his office is on coffee road. It just depends on what surgery you want. I hope this helps. Sue

I would think that you should get approval easier with BS than with Kaiser. Perhaps BS will take into consideration all that you have done with Kaiser as part of seeking approval. Don't get frustrated because I feel you have a better opportunity of getting surgery quicker now!

Go to www.blueshieldca.com look up their requirements.  Then you will also need to call and see if the employer purchased the benefit.  Take it easy right now. If you are wanting bypass the procedure code is 43644.  You will need that when you call the insurance company.  Also are you changing to an HMO or PPO plan.  Some of tha tis a ltttle bit different too.  If it is an HMO and the medical group is a full risk group the medical group will follow the general guidlines for surgery and they can add if they want you to wait for 6 mo year etc.  If it is a partial risk group the medical group is responsible to pay the doc and insurance pays faciltiy (hospital).  I hope that I have not confused you too much but I wanted you to know how it all works.
Liz