- On September 24, 2012
I’m a former patient of Dr. Mussalli and Dr. Worth who had a healthy baby girl with them on 11/27/11. I am in a PPO-only insurance plan, but I was able to obtain a waiver so that a large part of the cost (about half) was covered by insurance. I just wanted to share with you how I did it in case it’s helpful for future patients (and for Dr. Mussalli and Worth).
I was in a PPO-only BlueCross BlueShield plan. The plan had an exception where you could obtain a waiver for services performed by an out-of-network doctor if they were unique services that could not be obtained by an in-network doctor. This wasn’t covered in the plan materials, but I learned about it from speaking to representatives of BlueCross BlueShield.
I argued that “minimally invasive obstetrics” was a service that could not be easily obtained by an in-network doctor and cited the specific of skill with forceps, skill in administering non-epidural pain relief, and significant experience with natural childbirth. They accepted this argument. It also helped that I found a helpful person at Bluecross Blueshield to speak with and told her I would send a letter to her employer commending her client service 🙂
I hope this is helpful for anyone who was in my situation and who may be on the fence about switching to Dr. Mussalli and Dr. Worth. I was very lucky to be able to switch to them when I did. It was one of the best decisions I’ve ever made. I’ve attached a few pictures of my daughter, who just turned 9 months a few weeks ago.
All the best,