Christian,
In my case, I had an "out of pocket" deductible of $500. That means during a calendar year, I had to pay $500 in medical expenses before the remaining 100% would kick in.
Sometimes there are "additional costs" that they don't pay and they won't count towards a deductible. For example, Betty warned me to not have my shoulder "iced" after my physical therapy treatments. The insurance company doesn't consider ice pack treatments necessary.So, I could have therapy covered at 100%, but still have an outstanding bill because therapy included a procedure that wasn't covered.
You can call Blue Cross and tell them that your wife is scheduled for VR in November. Give them the name of the facility (Cleveland Clinic), the surgeon, and any cardiologist you might be using while you're there. Blue Cross can then tell you positively if all three are "in network" and if treatment by them will be covered at 100%. If they tell you that, you're in the clear. You should document whom you talked to and the date and time of the call.
Since you are "in network" all providers have to check precertification. As you said, if they don't, they're out of luck. It's when you go "out of network" that precertification falls on your shoulders.
I hope this helps.
Mary