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AllTheyEatIsLettuce t1_iy5irif wrote

>I get that it’s not the kind of emergency

It's not any kind of emergency if the customer received a recommendation to seek care elsewhere other than an emergency department/room. That's the insurance seller's position and it's not going to blink.

What you're asking (?) the insurance seller to do is make what's called a "network gap exception" in order for the customer to seek necessary health care from "OON" vendor(s) and have the insurance seller reimburse the vendor(s) at the "IN" rate. Assuming the vendor(s) agree to (1) take/accept/participate in the insurance seller's reimbursement scheme in general and (2) accept the reimbursement rate(s) for <something_here> in particular.

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