This is the most ridiculous position taken by an Insurance Company yet of not paying for ER stitches (WITH MY SON BLEEDING AWAY WHEN WE GOT THERE) My 3 year old son fell down and got a gash on his forehead. We rushed to the hospital at night and they determined he needed stitches. The hospital said they had a plastic surgeon on call who could do the stitches. We obviously needed to move quickly with whoever was available and the doctor did a great job giving my son about 6 stitches - poor baby was so weak with the bleeding so we had to stay several hours with drips till he had some energy to leave.
Next thing we get a $2200 bill from the plastic surgeon as BCBS refused to pay because he was OUT OF NETWORK in the ER. We wrote a letter to protest at the suggestion of the customer service representative to which the response was that the claim was still denied.
I can protest this a 100 times as this is absolutely ridiculous - How can anything be denied for an emergency? How am I supposed to know which doctor will be on call the day of my emergency????? Should I have let me son bleed away and how am I supposed to even know to check the network status of an ER doctor ?? How can BCBS would actually think of not paying in an emergency situation???