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I think it is normally the hospital or institution that is considered in or out of network rather than individual healthcare professionals.

I also have BCBS and didn't do ANY checking, haha. Everything turned out fine. I think as long as your hospital is in-network, you're good to go! Try not to worry about it too much.

That's really weird. I've never heard of that before and I worked in health insurance for a number of years. You should still be able to look up physicians that are considered in network online and I guess make sure those are the only ones you see??? It seems really odd to task a woman giving birth with that burden.

@daniellemybelle: I would call back the insurance, ask to speak with a supervisor, and explain what the hospital has told you. Ask what others have done previously as it's not realistic for you to ask every doctor, nurse, surgeon, etc that walks into your room whether they are in network with BCBS. I imagine they don't even know off hand.

@mediagirl: Ditto.

Your hospital probably has a set of anesthesiologists they work with. You can find out who they are and check to see if they accept BCBS. Also, if you needed a c-section, wouldn't it be with the on-call OB from your practice? If so, the whole practice should be in-network for your insurance.

BCBS is such a huge carrier, it's highly unlikely that any of the providers don't accept it. But on the off chance that someone doesn't, than you would just be responsible for what they charge you, not the entire bill.

The anesthesioligist and OB (if used) will be seperately from the hospital. They could be out of network. I tried to research the anesthesiologist part before going to the hospital and failed. I couldn't find any that were in network in my area. I got my epidural and hoped for the best. He was ultimately in network but I simply gave up (I knew I would want an epidural and knew that I would be willing to pay whatever was necessary if I was in pain).

You might ask the hospital more specific questions like who the oncall anesthesiologist is (or what company they are contracted with) and same for the OB. That is unless your midwife will call for a specific OB if needed.

@daniellemybelle: Yeah, the whole thing seems sketchy. I didn't even check at all - I just assumed everything would be fine, and it was! But I also didn't end up getting an epidural or having a c-section, so that probably helped.

I would think your insurance would have an 'out of control' clause for instances like this. you aren't going to sit around waiting for an in-network anesthesiologist/OB if you do end up needing either an epidural or C-section. I work in insurance(not BCBS) and so long as the hospital is in-network, we pay all claims for out-of network providers seen by a member(anesthesiologist, ER doc, other docs) as in-network, because you have no choice(control) over who sees/treats you.

@daniellemybelle: this is exactly what happened to me! the anesthesiologist was out of network. I received his entire bill but after a few phone calls, I worked it out. BCBS WILL cover it b/c they realize you did not have a choice in the matter, but it'll take some phone calls to both BCBS and the doctor's office - the claim has to be submitted in a certain way. BCBS sent the check directly to me, and I remitted it to the doctor's office.

@daniellemybelle: agreed! it was a pain in the butt with all the phone calls, but i will say that no one (BCBS or Dr) ever gave me grief about it. it clearly happens all. the. time.