[Maria]

If you have one as a provider then you pretty much can figure out what I'm going to say though I'll just keep it to this~ trying to get the specialist you choose or know about to be "qualified out of network specialist" that offers what no one in network can offer is the trick. It takes some doing tho I've seen it done before. My last employer was a Managed Care Company and just sometimes things can work to the patient's advantage. It takes near a miracle tho it actually can happen at least occasionally.

I know it's far easier to blow someone off and say that there is an in network specialist that does the same thing or that the insurance company isn't going to authorize "that" kind of procedure or surgery or whatever however with enough documentation and the right circumstances I'll say it again~ sometimes things do work out.

Judy I certainly hope you let the HMO know how things went for you with that particular situation. Sometimes the only way that these companies can figure out that they're wasting their money is to have people continue to complain and see if the company had perhaps just authorized the first thing requested they could have saved several other consultations, procedures etc.

People/patients do have to report things that don't work out well for them however and many people don't go any further than calling Member Services and complaining vs. writing to the CEO of the company and really filing a grievance or something of that nature. In Managed Care/HMOs sometimes it is that squeaky wheel that gets oiled vs. just ignored!