Re: self-pay/insurance coverage

[Guest guest]

Hi a: I am in the same position as you and had

the same question. I live in California and my

friend's husband was formerly a high officer of the

California Dept. of Insurance. I asked himn about

this last week. He told me that I could selfpay and

continue to bug my insurance co. (Cigna) for

reimbursement BUT that my chances of having Cigna pay

would be lower than if I just continued to fight them.

He said that by paying myself, I would mitigate my

damages, thereby lowering the chances of Cigna coming

through.

I am also at a point where i want to get this surgery

scheduled and may end up self paying if i can't get

this resolved in the next few weeks. Good luck to you

--- a Mease-White alexa@...>

wrote:

> Hi everyone--

>

> I got my first ding from the insurance

> company--Anthem BC/BS--I was

> expecting it, and actually, the lady I talked to was

> very helpful re:

> the appeal and very optimistic that I'd eventually

> get coverage.

> Believe me, I'll dog this darned company until they

> approve me! Hee

> hee

>

> Now that I've found this wonderful surgery, I can't

> bear wading

> through months of insurance hell, plus the summer is

> a far better

> time

> for me in terms of scheduling. So, I'm thinking

> I'll submit my

> packet

> and plan to self-pay if insurance hasn't come

> through yet.

>

> My question to you guys--I've noticed that many of

> you have self-paid

> while duking it out with your insurance company and

> eventually got

> insurance to pay--I'd love to hear from

> anyone/everyone who's done

> this. How does it work--when you get insurance to

> pay (I'm totally

> optimistic here that insurance WILL come through),

> do they reimburse

> you directly? And do your chances for coverage

> decline once you've

> paid for it yourself?

>

> Thanks so much for your help--

>

> --a in CT

>

>

>

__________________________________________________

[Guest guest]

I don't know anything about Anthem BC/BS but my insurance is a subsidiary of

BC/BS. I got an initial denial but did not have to go through a formal

appeal process. I educated them on the procedure and why I preferred it,

emphasized significantly less expensive. They wanted me to stay in network

but relented when this procedure was not available in network (surprise).

Good Luck, Darlene

a Mease-White wrote:

> Hi everyone--

>

> I got my first ding from the insurance company--Anthem BC/BS--I was

> expecting it, and actually, the lady I talked to was very helpful re:

> the appeal and very optimistic that I'd eventually get coverage.

> Believe me, I'll dog this darned company until they approve me! Hee

> hee

>

> Now that I've found this wonderful surgery, I can't bear wading

> through months of insurance hell, plus the summer is a far better

> time

> for me in terms of scheduling. So, I'm thinking I'll submit my

> packet

> and plan to self-pay if insurance hasn't come through yet.

>

> My question to you guys--I've noticed that many of you have self-paid

> while duking it out with your insurance company and eventually got

> insurance to pay--I'd love to hear from anyone/everyone who's done

> this. How does it work--when you get insurance to pay (I'm totally

> optimistic here that insurance WILL come through), do they reimburse

> you directly? And do your chances for coverage decline once you've

> paid for it yourself?

>

> Thanks so much for your help--

>

> --a in CT

>

> ------------------------------------------------------------------------

> Air purifiers, bedding, household cleaning & more! gazoontite.com!

> http://click.egroups.com/1/5492/3/_/453517/_/962242821/

> ------------------------------------------------------------------------

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

[Guest guest]

I don't know anything about Anthem BC/BS but my insurance is a subsidiary of

BC/BS. I got an initial denial but did not have to go through a formal

appeal process. I educated them on the procedure and why I preferred it,

emphasized significantly less expensive. They wanted me to stay in network

but relented when this procedure was not available in network (surprise).

Good Luck, Darlene

a Mease-White wrote:

> Hi everyone--

>

> I got my first ding from the insurance company--Anthem BC/BS--I was

> expecting it, and actually, the lady I talked to was very helpful re:

> the appeal and very optimistic that I'd eventually get coverage.

> Believe me, I'll dog this darned company until they approve me! Hee

> hee

>

> Now that I've found this wonderful surgery, I can't bear wading

> through months of insurance hell, plus the summer is a far better

> time

> for me in terms of scheduling. So, I'm thinking I'll submit my

> packet

> and plan to self-pay if insurance hasn't come through yet.

>

> My question to you guys--I've noticed that many of you have self-paid

> while duking it out with your insurance company and eventually got

> insurance to pay--I'd love to hear from anyone/everyone who's done

> this. How does it work--when you get insurance to pay (I'm totally

> optimistic here that insurance WILL come through), do they reimburse

> you directly? And do your chances for coverage decline once you've

> paid for it yourself?

>

> Thanks so much for your help--

>

> --a in CT

>

> ------------------------------------------------------------------------

> Air purifiers, bedding, household cleaning & more! gazoontite.com!

> http://click.egroups.com/1/5492/3/_/453517/_/962242821/

> ------------------------------------------------------------------------

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

[Guest guest]

I don't know anything about Anthem BC/BS but my insurance is a subsidiary of

BC/BS. I got an initial denial but did not have to go through a formal

appeal process. I educated them on the procedure and why I preferred it,

emphasized significantly less expensive. They wanted me to stay in network

but relented when this procedure was not available in network (surprise).

Good Luck, Darlene

a Mease-White wrote:

> Hi everyone--

>

> I got my first ding from the insurance company--Anthem BC/BS--I was

> expecting it, and actually, the lady I talked to was very helpful re:

> the appeal and very optimistic that I'd eventually get coverage.

> Believe me, I'll dog this darned company until they approve me! Hee

> hee

>

> Now that I've found this wonderful surgery, I can't bear wading

> through months of insurance hell, plus the summer is a far better

> time

> for me in terms of scheduling. So, I'm thinking I'll submit my

> packet

> and plan to self-pay if insurance hasn't come through yet.

>

> My question to you guys--I've noticed that many of you have self-paid

> while duking it out with your insurance company and eventually got

> insurance to pay--I'd love to hear from anyone/everyone who's done

> this. How does it work--when you get insurance to pay (I'm totally

> optimistic here that insurance WILL come through), do they reimburse

> you directly? And do your chances for coverage decline once you've

> paid for it yourself?

>

> Thanks so much for your help--

>

> --a in CT

>

> ------------------------------------------------------------------------

> Air purifiers, bedding, household cleaning & more! gazoontite.com!

> http://click.egroups.com/1/5492/3/_/453517/_/962242821/

> ------------------------------------------------------------------------

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm