Favorite pediatricians for BCBS

sy5temfire · June 2014

Not familiar with any WPAHS peds offices. Worried about the UPMC/Highmark switch-over if it happens in Jan. Any recomendations? Central Pgh/Oakland preferred.

monkyciti · June 2014

I am curious as well. I live in the North Hills though. I will be delivering at WPAHS too.

PacoCat33 · June 2014

From what I understand, any pediatrician that does rounds at Children's will still be okay if highmark and UPMC can't get it together by Jan. 1. Children's and Western Psych will always accept both insurances (at least as of now). Also, for specialist doctors, if they do surgery/rounds at a UPMC and another hospital other than UPMC (West Penn, Jefferson, Allegheny General, etc)...then you can keep seeing them.

This whole thing is so ridiculous! I don't understand why they can't get their act together!

Allison7 · June 2014

PacoCat33 said:

From what I understand, any pediatrician that does rounds at Children's will still be okay if highmark and UPMC can't get it together by Jan. 1. Children's and Western Psych will always accept both insurances (at least as of now). Also, for specialist doctors, if they do surgery/rounds at a UPMC and another hospital other than UPMC (West Penn, Jefferson, Allegheny General, etc)...then you can keep seeing them. This whole thing is so ridiculous! I don't understand why they can't get their act together!

This. When I checked with my insurance about delivery, the rep said that Magee, Western Psych, and Children's were all fine, regardless of the outcome. Those hospitals signed a separate agreement to accept all insurances due to the specialized nature of the care they offer.

mc0113 · June 2014

Allison7 said:

PacoCat33 said:

From what I understand, any pediatrician that does rounds at Children's will still be okay if highmark and UPMC can't get it together by Jan. 1. Children's and Western Psych will always accept both insurances (at least as of now). Also, for specialist doctors, if they do surgery/rounds at a UPMC and another hospital other than UPMC (West Penn, Jefferson, Allegheny General, etc)...then you can keep seeing them. This whole thing is so ridiculous! I don't understand why they can't get their act together!

This. When I checked with my insurance about delivery, the rep said that Magee, Western Psych, and Children's were all fine, regardless of the outcome. Those hospitals signed a separate agreement to accept all insurances due to the specialized nature of the care they offer.

Magee is not included per the release yesterday.

"Only UPMC's rural hospitals — Northwest, Bedford, Hamot, Horizon and Altoona — along with doctors and associated clinics of those hospitals, will remain in-network next year. Two specialty medical centers in Pittsburgh — Children's Hospital of Pittsburgh and Western Psychiatric Institute and Clinic — also will be in-network. It does not include Magee Womens Hospital."

https://www.wpxi.com/news/news/local/upmc-highmark-agree-limited-basis-continue-care-se/ngSpN/?__federated=1

sy5temfire · June 2014

Agreed. I just switched from Magee to Pittsburgh Gyn Obs this week to now deliver at WPH. Not too happy about leaving Dr Poutous. He's amazing and guided me through my LEEP but I did all my nursing school clinical at WPH including ob/gyne rotation. My first nursing position was there and glad a lot of my friends will be able to visit me while on break after we've had our little nugget. I think I'm going to go with Kids Plus to avoid the whole CHP/UPMC debacle that that could arise if this drama progresses.

Favorite pediatricians for BCBS

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