Re: Re: Re. PPO vs. HMO - NOTE!

[Guest guest]

In a message dated 08/29/2001 3:09:25 PM Central Daylight Time,

caramianyc@... writes:

> Are you saying that Blue Cross PPO is bad? or good...lol...

> I have Empire Healthchoice PPO, which I think is part of the Blue

> Cross Companies...Does anyone have this insurance, and if so, did

> they pay for the BPD/DS????????

>

I had BC/BS and was approved within ten days of the letter being sent. I

must say again that because the BPD/DS does not have its own distinct

procedure code, it can make a big difference in how the doctor words the

letter in getting approval.

Dawn----South suburban chicago area

Dr. Hess, Bowling Green, OH

BPD/DS

4/27/00

www.duodenalswitch.com

267 to 165 5' 4 "

size 22 to size 10

have made size goal

no more high blood pressure, sore feet, or dieting!

[Guest guest]

I had BC/BS and was approved within ten days of the letter being sent. I

must say again that because the BPD/DS does not have its own distinct

procedure code, it can make a big difference in how the doctor words the

letter in getting approval.

Dawn----South suburban chicago area

Dr. Hess, Bowling Green, OH

================================================================================\

============

Dawn,

Hi ! I've got my consult with Dr. Hess in October. My insurance is with

Cigna (HMO) here in N. Carolina.

To the best of your knowledge, does Dr. Hess typically have good

'acceptance' rate with the letter he

submits ? I've got letters from 4 of my local docs (internist, podiatrist,

and two surgeons) to backup the

fact that this is medically necessary (along with an 11 page typed document

of diet history, family medical

history, etc,...), so I'm hoping this may go a little more smoothly than I

anticipate.

It's the first time in years that I've felt hope, and I'm scared to death

that it's going to be shattered. I

think that's the worst part of being pre-op ... just knowing someone else

can deny you what is needed.

But then again, I suppose it's something we all go through trying to get

ready )

Thanks for any info you have.

Bye,

Donna

[Guest guest]

I think they've changed their policies since the time you had your surgery,

though.

alyssa

Re: Re: Re. PPO vs. HMO - NOTE!

> I had BC/BS and was approved within ten days of the letter being sent. I

> must say again that because the BPD/DS does not have its own distinct

> procedure code, it can make a big difference in how the doctor words the

> letter in getting approval.

>

> Dawn----South suburban chicago area

> Dr. Hess, Bowling Green, OH

> BPD/DS

> 4/27/00