... Is there anyone out there who has ever had success with a 2nd level appeal with BCBS? ... (0 replies)
... In your appeal send along any records you have of the actual diagnosis of infection. ... (3 replies)
... 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)
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)
... 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)
... A couple things to consider. 1. tooth pain is not life threatening, and yes I know it hurts, but you will not die from it. And because of this medical insurance will not cover it.
Second issue is, if it were a covered service and you waited 5 days to go to the ER, the insurance company would say that in that 5 day timeframe you could have gone to a dentist or an urgent care... (3 replies)
... Hi My wife and I just got our first denial for IVF/PGD from Blue Cross Blue Sheild of Mass. We sent them several letters from our DR's and one from us and our awaiting the appeal. (2 replies)
... And my husband went to the physical BCBS asked him to go to because he hadn't been to a doctor in so long. The physician wrote something incorrect on his record, that he had a history of skin cancer. ... (7 replies)
... I'm going through an appeal with BCBS over denying my application. ... (4 replies)