Physicians Choice Medical Group

Review: I need to have my aortic valve (heart valve) replaced. This was discovered in March 2014. I was approved to have my valve replaced at French Hospital and had a date set in September 2014 and was approved for this by Physicians Choice Medical Group (PCMG). The doctor, Dr. [redacted] chose not do it after he was informed that I had Hep C and an intermittent bleed somewhere in the digestive tract that to this day can't be found.I was then approved by PCMG to have the valve replaced at French Hospital with Dr. Doria, using the TAVR procedure. Dr. [redacted] found that my valve opening was too big for the valves that he uses (they are made by Edwards). I spoke with Edwards and they confirmed that they did not make this size valve. On my own, I then found a Dr. who uses the Core Valve made by Medtronics that is my size. This valve was approved by the FDA for use on June 12, 2014. This Dr., [redacted] at Cedars Sinai Hospital in Beverly Hills, even went so far as to make an appointment with me pending insurance approval. It should be noted that I have Blue Shield HMO and Cedars does accept Blue Shield HMO. PCMG (contractor of Blue Shield) does not have a contract with Cedars so they denied my request for treatment there. This treatment request was made through my cardiologist, Dr. [redacted] in SLO to PCMG.Therefore, I am left with either having an extremely risky surgery through the chest possibly locally, or having PCMG allowing care to a paying customer who needs a special procedure and has unusual medical needs (me).Considering all of the money that I have paid for medical insurance over the years, I would expect to get services that I have paid for. PCMG is denying my required and life sustaining services even though they, through Blue Shield HMO, have received payment for said services.Desired Settlement: I would like this matter resolved by having my life sustaining procedure completed and paid for by the company (Physicians Choice Medical Group)that I make monthly payments to for this very reason.