Guest guest Posted October 3, 2001 Report Share Posted October 3, 2001 In a message dated 10/03/2001 2:18:46 PM Central Daylight Time, jfmsw1999@... writes: > I live in chicago and i was going to go to Bloomfield hills michigan > with Dr. Lutzski-- SP? anyway, i have open enrollment in november at > work and i was going to change from HMO to the PPO. Now are you > saying that BCBS PPO may not cover the DS?? I have a blue cross/blue shield of IL plan. I went to Dr. Hess and his letter worked magic. They approved almost immediately. It makes a big difference how the doctor words the letter since there is no specific code for the DS. Keep the term DS out of it and let the doctor (in Dr. Hess's case anyway) do their thing. I did have surgery a while ago, but know of someone who had surgery in June with BC/BS of IL. They had no problems. One thing you might want to get together now is a weight history. I had gotten this from my doctor and sent it in with the surgeon's letter. I had heard of others needing this and didn't want any delays by them asking for it and having to wait for them to look at it again. 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 2001 Report Share Posted October 3, 2001 In a message dated 10/3/01 3:18:54 PM Eastern Daylight Time, jfmsw1999@... writes: << If you have a PPO and you go to a contracted suregon then they agree > to accept the contracted amount and you are usually only responsable > for 10-20% of the cost up to an out of pocket maximum. If you go out > of network then you are responsible for typically 30-40% of the >> Bcbs PPo is all different; I have that, BCBS PPO of Illinois, but they just handle it for my employer who is actually the one who pays in the end. If I go within network the dr accepts what they pay I pay nothing after a $150 yearly deductible toward all my health care. Out of network they pay 90%. So each contract is different. They said they'd pay for WLS surgery, whether the DS remains to be seen. I'll know soon. Sheryl Quote Link to comment Share on other sites More sharing options...
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