Primary HMO and Secondary PPO Question
My surgeon's office submitted a RNY request to my secondary insurance (thru my hubby) which is Blue Cross PPO. The do cover bariatric surgery however, they responded to my surgeon's office that they are my secondary insurance. My husband called Blue Cross and they said they'll cover the surgery if they get a letter of denial from my primary insurance through my job (HealthNet HMO). The insurance coordinator at my surgeon's office is saying that I may need to go through my HealthNet HMO primary insurance. But that would mean I don't get to use the surgeon I choose (and he accepts Blue Cross PPO). Has anyone been penalized for having both a primary and secondary insurance like this?
Thank you Paul!
It seems now that my surgeon's office wants my primary care physician to submit an "outside referral" to my primary insurance (HealthNet) requesting retroactive coverage for the 2 visits I've already made to my surgeon. If they approve it, the insurance coordinator thinks it will be easy to have my primary insurance cover it. Luckily, the surgeon does accept HealthNet...but he's just not in the medical group that my primary care physician is in.
It's all so complicated. Thanks for your support!
Lisa