New to Blue Sheild PPO and can’t figure out when I do or don’t need a preauthorization.

My primary sent me for an ultrasound today. I'm literally brand new to Blue Shield PPo and have never worked with anything like this before.

Went to the website to see if I needed a preauthorization for it.

Found my way to a PDF file thst said 2024 Preaauthorization list. Sounds easy right?

That PDF contained 4 pages of "procedure codes." I have zero clue what procedure code an ultrasound is because it didn't say.

Called on the phone and the representative looked it up and said that no preauthorization was needed for that.

All well and good, but later when I get a huge bill and they say it required a pre-auth, what am I supposed to do? Tell them that "Melanie on the phone" said I didn't need one?

There has to be some way to find out what does and doesn't require one and get it in writing so there are no misunderstandings.

What am I missing here?

submitted by /u/Cali_kink_and_rope
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