@rootcause93 Hi I hope I can help a bit and I am familiar with your situation very well. I had BCBS of Arizona and only dealt with California a couple of times for unrelated May Care. But for BCBS in general your story sounds very familiar. Based on my research and what I've been told is BCBS does not have a regular contract with Mayo so you probably fall under what is called Non Participating Provider which is 2 to 3 times more expensive than if they did have a contract. Now I was originally transferred to Mayo for a possible Heart Transplant evaluation which is one of the exceptions to the above rule with a catch is BCBS will pay for a transplant and all follow-up up to 1 year and its to the day. So for me that was a huge amount of money and I am thankful for that. But that ran out now over 2 years ago and due to some blood issues i needed treatment after the one year mark. Well like you I was told I was approved for this treatment which is rather expensive each visit is like 9000.00. So I believed at the time i was covered, what i did not know was it was at the non participating provider rate. Now also realize i had secondary Insurance of Tri Care Prime at the time being I'm retired Military which did help but my out of pocket is about 35% of what the insurance doesn't pay. I found this out after the fact and had to bite the cost and I probably would have gone elsewhere but I became eligible for Medicare with a better Tricare for Life plan that pretty much pays 100%.
So bottom Line what will probably happen if California is like Arizona is BCBS will send you a check for what they would be willing to pay for that service at the non participating provider rate which was 35% of the customary charge they recognize for out of network facilities. So It could get expensive if the office visit alone is 5000. I can see you probably paying about 35% or more of that amount. Now an additional question is do you have a secondary Insurance? Sometime the secondary insurance will actually pay more if they have a regular contract with Mayo. Also If I were you I would contact Mayo and get proof of the approval and take that to BCBS. Not everyone I have run into at BCBS or MAYO is an expert on all things financial. I had to go to bat with BCBS a few time on getting treatment when one person say something different than another. If Mayo has proof of the approval than you will have evidence to address it with BCBS. Good Luck I also will state that I did receive lots of support from the social worker folks at Mayo who can help facilitate some of these issues. If this is something that may run into long term care and I personally do Love the folks at Mayo Great people all around. I would say that Mayo is pretty good about working out payment plans also.
I hope this helps and if I can answer any other questions please ask.
Dana