A brief search yielded the name of a physician who specializes in treating my issue, is considered one of the best in the area, and was listed as in-network for my insurance. I called his office to make an appointment. He is accepting new patients: Score! But wait:
"We don't participate in [Amber's Insurance]."I called my insurance, and sure enough, half of the addresses listed for this doctor are in-network and half are not. All of the surgical centers listed on the doctor's website are also allegedly in-network, per the insurance website, although who knows---at least a hospital location is not going to have multiple addresses, but I wouldn't be surprised to learn that somehow that doesn't matter. One of them is the giant hospital with the babies. Maybe anything that needs to be done can be done there? Clearly a question for the doc.
"But the insurer website says you are in their network."
"Yes, the doctor's practice at [Giant University Hospital] is. He sees the babies there. But his private practice is not. You can submit the claim for reimbursement or we can submit it for you."
" .... Okay. [Throws up hands, makes appointment.]"
So basically I get to pay out-of-network (80/20) rates to see an in-network physician, and maybe out-of-network rates for any surgery he decides to do, because I am not a baby. Certainly I could try to find someone else, but this fellow apparently helps people who other doctors say nothing can be done for, and I'm tired of being brushed off with non-solutions when there are newer procedures that could potentially resolve the issue.**
* Not even the same ophthalmologist I saw in the immediate aftermath of Double-Vision-Fest 2007, who apparently moved and left all her patients to non-specialist-in-Amber-issue doc. And have I mentioned that I am still CURSING the random optometrist who lured me in with a coupon for a free eye exam and shiny frames and started this whole mess? I could cope just fine until then!
** Not that I have some principled objection to paying for care above and beyond the status quo as of N years ago, but having to pay because of addresses strikes me as perverse. Your doctor's in-network ... oh no he isn't! Grrr.