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Health Insurance SSDI Issues Board Index
Pages: 1 2 3 Showing 1 - 20 of 60 for bcbs appeal. (0.008 seconds)

... I've been around the insurance rig-a-ma-roll quite often. Insurance can deny based specifically on diagnosis alone. The insurance system is set up to deny claims....think of it that way. There isn't much the insurance doesn't catch. So you have to be smarter than it. Did you make your appointment for a routine physical? I think you said yes...therefore, you need to contact the... (4 replies)
... While googling out on how to do a BCBS Appeal, I encountered this site. After reading several appeal threads here, I think my case is much simpler. ... (4 replies)
... Is there anyone out there who has ever had success with a 2nd level appeal with BCBS? ... (0 replies)

... Also, have it resent as an appeal. If they just simply resubmit the claim even with a different diag. code the computer will/may just simply deny as previously submitted/denied. The people who receive you claim and imput it into the computer don't review the claim, just plug in the numbers and the computer is programed to automatically ajudicate/process it with no decision by... (4 replies)
BCBS Appeal
Mar 1, 2009
... In your appeal send along any records you have of the actual diagnosis of infection. ... (3 replies)
BCBS Appeal
Feb 2, 2009
... I have BCBS Preferred Care. I recently went to the ER on a Sunday after waking up the Tuesday prior to this with severe tooth pain. ... (3 replies)
... I am in my own fight...but it sounds like to me that BCBS is giving you the run around...if they cannot provide a name of a provider for air transport, what are you supposed to do? ... (11 replies)
... ion of Benefits letter,but Health Board policy states we can't have direct contact other than posting. I'll copy our replies and try and run with that at my next appeal meeting. ... (11 replies)
... Gemi Lee, The only question I have left is the type of policy you have with BCBS. The terms of my PPO states that if I use an approved transport carrier, I was to pay 10% plus annual deductible.The rub being again that BCBS's information network would or couldn't provide to me the name of a network provider. Do you still have BCBS's letter Explanation of Benefits that... (11 replies)
... I'm sorry to hear about your situation with BCBS they can be a pain in the butt. ... (11 replies)
... Hi Gemi Lee, I had to stay in the hospital for five days due to a sudden drop in my Red blood count. They thought they might have torn a vessel during implant. Shortly after, I developed allergic reactions to lipitor and Plavex, then developed "Trash Foot" where embolisms migrated to my feet blocking circulation and caused my toes to turn " Black and Blue". Luckily,... (11 replies)
... Heymike, Yep, I doing just fine had to have more heart stents put in a few months ago. Oh well at least I didn't have another heart attack....LOL Did you have to stay in the hospital for several days after your heart attack? what is your out of pocket amount? That sounds awful high.:eek: They wanted me to pay the full amount $9175.00 since they didn't think it was... (11 replies)
... Hi Gemi Lee, Hope you have recovered well. My BCBS policy is a PPO and BCBS stated that according to this contract they paid the maximum for the air service that returned me to the US for treatment- $3000. I saw where you were reimbursed significantly more and was wondering what type policy or circumstance of your incident would warrant a larger refund. How far were you... (11 replies)
... Hi Mike, I can tell you what I did in my situation. Is that what your wanting to know how my process went with the appeal? What kind of documents I had to submit etc.? (11 replies)
... i don't know the answer to this question but I do think that medicare or bcbs should be able to answer the question. I think it is terrible that bcbs did not advise you of this before hand. ... (9 replies)
... Contact BCBS and ask for an explanation and check with them. Tell them you want any reasoning for refusing an assistant in writing and then you can appeal. ... (4 replies)
... I'd start by asking the Dr. if it is truly necessary. If Medicare and the BCBS plan has been determined that it is not necessary, there may be something behind that. If Dr. ... (4 replies)
... plus my usual copay because BCBS will not pay for an assistant during the surgery. ... (4 replies)
BCBS Appeal
Jun 6, 2009
... That is awful that they said they will not cover. Like the previous poster Infection could get much worse and spread. I have been in that boat before I got an absess and the dentists office was on vaca and my gum got infected and the whole half of my face was soooo swollen and painful, It looked awful. The infection could also spread, I hope by now they have covered it. It... (3 replies)
... Hi! When claims was received by the insurance, the first thing they match was the procedure codes and diagnosis code. If your doctor was billing for the annual physical exam yet the diagnosis code was not preventive. This would definitely be denied. Insurance has the list of their procedure codes and diagnosis code that would fall for preventive services. The provider needs... (4 replies)

Associated Tags: heart stents

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