Guest guest Posted June 7, 2000 Report Share Posted June 7, 2000 mgb 5/3/00. minus approx 40#, gone forever. doing great. however, insurance -bcbs of tn precerted my surgery, it was not listed in my handbook as an excluded benefit in any shape form or fashion, i spent a great deal of time preop with the insurance co. was told if it was preapproved and was not listed as an exclusion it was covered. was precerted for a 3 day hosp stay. got my eob the other day, anesthesia was paid, dr. rutledge office visit was paid. HOSPITAL NOT PAID. stated excluded benefit. i have been at war with bcbs since. they read me a specific exclusion for any treatment of diagnosis obesity, including supplies, surgery, etc. but it was not in my handbook. bcbs said they would fax me their statement from the policy BUT LATER CHANGED THEIR MIND and will not provide it to me. my human resources dept will neither confirm nor deny the exclusion and will not provide me any additional documentation beyond my employee benefits booklet which does not list the exclusion. they suggest i appeal with blue cross. fortunately for me i have a secondary policy that will pay an out of network rate so i will end up paying less than i could have until/if ever i get this straight with bcbs of tn & my company. just a word to the wise, just because they say they pay don't always make it so.! kimberly Quote Link to comment Share on other sites More sharing options...
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